MEDICARE: MRS. MERCY HUNG CHIU PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	28748	CA

General Provider Information

NPI Number	:	1568586170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MERCY HUNG CHIU PT

Provider Business Mailing Address
First Line	:	2519 LAS GALLINAS AVE
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903
Country	:	US
Telephone Number	:	650-307-3919
Fax Number	:

Provider Business Practice Location Address
First Line	:	2519 LAS GALLINAS AVE
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94903-1422
Country	:	US
Telephone Number	:	650-307-3919
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	05/21/2021

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