Healthcare Provider Details

I. General information

NPI: 1689337834
Provider Name (Legal Business Name): CHIA-HUA CHAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHIA-HUA CHAN DR. CHIA-HUA,CHAN DC

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 RED HILL AVE STE 11
SAN ANSELMO CA
94960-2469
US

IV. Provider business mailing address

3909 STEVENSON BLVD STE D
FREMONT CA
94538-2301
US

V. Phone/Fax

Practice location:
  • Phone: 415-444-6965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number36104
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: