MEDICARE: DR. PO CHUA HER D.C.

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	111N00000X	Chiropractor	DC28085	CA

General Provider Information

NPI Number	:	1679587711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PO CHUA HER D.C.

Provider Business Mailing Address
First Line	:	75 W MARCH LN STE J
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-5729
Country	:	US
Telephone Number	:	209-474-1330
Fax Number	:	209-474-7859

Provider Business Practice Location Address
First Line	:	75 W MARCH LN STE J
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95207-5729
Country	:	US
Telephone Number	:	209-474-1330
Fax Number	:	209-474-7859

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	10/08/2008

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Directions to “ DR. PO CHUA HER D.C.” Practice Location

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