Park, Jae Chang
Park, Jae Chang is an sole proprietor health care provider with primary practice located at 940 E Main St , Santa Maria CA 93454-5331. He recently has only one registered license in Other Service Providers / Acupuncturist, which is considered as his primary health care specialty. Park, Jae Chang can be contacted via phone (805) 332-9839.Contact Information
Primary practice address
940 E Main St
Santa Maria CA 93454-5331
Phone: (805) 332-9839
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Acupuncturist | 171100000X | AC 10209 | California |
Profile Details
| NPI number | 1255463675 |
|---|---|
| LBN Legal business name | Park, Jae Chang |
| Credentials | Licensed Acupuncturist (LAC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Jan 26th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255463675 | NPPES |
| California | Other | AC 10209 | ACUPUNTURIST |
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