Individual provider Active NPI

Guang Di Chang, ACUPUNCTURIST

  • Acupuncturist
  • San Diego, CA
National Provider Identifier
1477705705
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC12747 Issued in CA
Practice address
6727 Flanders Dr Ste 107
San Diego, CA 92121-2926
Phone
(626) 581-7828
Fax
(626) 581-7829
NPI assigned
Oct 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC12747 CA Primary

Addresses

Primary practice location

6727 Flanders Dr Ste 107
San Diego, CA 92121-2926

Mailing address

6727 Flanders Dr Ste 107
San Diego, CA 92121-2926
Phone (626) 581-7828

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
AC12747CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Mylife Acucenter, Inc. Acupuncturist CurrentSince Feb 26, 2023 Accepting new patients

Locations

6727 Flanders Dr
Ste 107
San Diego, CA 92121
Phone (619) 324-9009

16486 Bernardo Center Dr
Ste 100
San Diego, CA 92128
Phone (619) 888-8862

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1477705705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6727 FLANDERS DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212926",
            "telephone_number": "626-581-7828",
            "fax_number": "626-581-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6727 FLANDERS DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921212926",
            "telephone_number": "626-581-7828",
            "fax_number": "626-581-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "GUANG DI",
        "credential": "ACUPUNCTURIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-17",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.