Healthcare Provider Details

I. General information

NPI: 1619435658
Provider Name (Legal Business Name): EDWARD CHU MOVEMENT SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 HALLMARK DR STE 1
SACRAMENTO CA
95825-2212
US

IV. Provider business mailing address

2041 HALLMARK DR STE 1
SACRAMENTO CA
95825-2212
US

V. Phone/Fax

Practice location:
  • Phone: 916-488-4849
  • Fax: 916-929-3299
Mailing address:
  • Phone: 916-488-4849
  • Fax: 916-929-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: ANNETTE TOTH
Title or Position: OFFICE MANAGER
Credential:
Phone: 916-488-4849