Individual provider Active NPI

Mandy Manshu Chang

  • Acupuncturist
  • San Gabriel, CA
National Provider Identifier
1215264569
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC12160 Issued in CA
Practice address
206 E Las Tunas Dr Ste 1
San Gabriel, CA 91776-1411
Phone
(626) 926-6666
NPI assigned
Nov 6, 2009
Last updated
Nov 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC12160 CA Primary

Addresses

Primary practice location

206 E Las Tunas Dr Ste 1
San Gabriel, CA 91776-1411

Mailing address

6212 N del Loma Ave
San Gabriel, CA 91775-2506
Phone (626) 926-6666

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC12160CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1215264569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6212 N DEL LOMA AVE",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917752506",
            "telephone_number": "626-926-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E LAS TUNAS DR STE 1",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761411",
            "telephone_number": "626-926-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "MANDY",
        "middle_name": "MANSHU",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.