Healthcare Provider Details

I. General information

NPI: 1053103051
Provider Name (Legal Business Name): DR. PATRICK L. CHU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 BUCHANAN ST STE 203
SAN FRANCISCO CA
94123-1779
US

IV. Provider business mailing address

44176 IBERO WAY
FREMONT CA
94539-6300
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-1655
  • Fax:
Mailing address:
  • Phone: 510-304-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number35232
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: