Healthcare Provider Details

I. General information

NPI: 1306740865
Provider Name (Legal Business Name): MARISA CHU DC
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21629 STEVENS CREEK BLVD
CUPERTINO CA
95014-1169
US

IV. Provider business mailing address

21629 STEVENS CREEK BLVD
CUPERTINO CA
95014-1169
US

V. Phone/Fax

Practice location:
  • Phone: 408-657-6331
  • Fax:
Mailing address:
  • Phone: 408-657-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37481
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: