Individual provider Active NPI

Charles Jung Chao Kwang, D.C.

  • Chiropractor
  • Arcadia, CA
National Provider Identifier
1194756551
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28111 Issued in CA
Practice address
65 N 1St Ave
204
Arcadia, CA 91006-3207
Phone
(626) 786-7704
Fax
(626) 810-0113
NPI assigned
Jul 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28111 CA Primary

Addresses

Primary practice location

65 N 1St Ave
204
Arcadia, CA 91006-3207

Mailing address

PO Box 883
Monterey Park, CA 91754-0883
Phone (626) 786-7704

Other identifiers 3

IdentifierTypeStateIssuer
DC0281110OtherCAMEDICAL NUMBER
DC28111OtherCAPPO NUMBER
DC0281110OtherCABLUESHIELD NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC28111CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chok P Wan MD Inc PastSince Sep 12, 2011 Accepting new patients
R Tseng Chiropractic Corp Chiropractor Past Accepting new patients
Chok P. Wan M.D., Inc. Past Accepting new patients
Chang Chiropractic Healthcare Clinic Chiropractor Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194756551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 883",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917540883",
            "telephone_number": "626-786-7704",
            "fax_number": "626-810-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N 1ST AVE",
            "address_2": "204",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063207",
            "telephone_number": "626-786-7704",
            "fax_number": "626-810-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWANG",
        "first_name": "CHARLES",
        "middle_name": "JUNG CHAO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL NUMBER",
            "identifier": "DC0281110",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO NUMBER",
            "identifier": "DC28111",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD NUMBER",
            "identifier": "DC0281110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.