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General NPI Number Information
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NPI Number | 1346476686
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Entity Type | Organization
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Legal Business Name | CHU CHIROPRACTIC, INC
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 1615 S AZUSA AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-3832
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Country | US
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Telephone | 626-810-5559
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Fax | 626-810-0037
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Provider Business Mailing Address
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Address Line | 1615 S AZUSA AVE
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745-3832
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Country | US
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Telephone | 626-810-5559
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Fax | 626-810-0037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY CHU
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Credential | D.C.
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Telephone | 626-810-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC28643
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License Number State | CA
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