Healthcare Provider Details

I. General information

NPI: 1629479167
Provider Name (Legal Business Name): SPENCER HAU CHIROPRACTIC CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20570 VALLEY GREEN DR NONE
CUPERTINO CA
95014-1702
US

IV. Provider business mailing address

20570 VALLEY GREEN DR NONE
CUPERTINO CA
95014-1702
US

V. Phone/Fax

Practice location:
  • Phone: 408-345-5590
  • Fax: 408-498-4551
Mailing address:
  • Phone: 408-345-5590
  • Fax: 408-498-4551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number32692
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number32692
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32692
License Number StateCA

VIII. Authorized Official

Name: DR. SPENCER R HAU
Title or Position: CEO
Credential: DC
Phone: 408-345-5590