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General NPI Number Information
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NPI Number | 1457628307
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Entity Type | Organization
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Legal Business Name | DALY CITY CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 151 87TH ST STE 4
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City | DALY CITY
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State | CA
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Zip | 94015-1696
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Country | US
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Telephone | 650-757-7777
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Fax | 650-757-3336
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Provider Business Mailing Address
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Address Line | 151 87TH ST STE 4
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City | DALY CITY
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State | CA
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Zip | 94015-1696
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Country | US
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Telephone | 650-757-7777
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Fax | 650-757-3336
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. VICTOR SHU
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Credential | D.CL
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Telephone | 650-757-7777
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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 | DC29005
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC27688
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License Number State | CA
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