Provider Demographics
NPI:1093226755
Name:CHIEN CHU, CHENG CHIEH (DAOM, LAC, DIPLOM)
Entity Type:Individual
Prefix:DR
First Name:CHENG CHIEH
Middle Name:
Last Name:CHIEN CHU
Suffix:
Gender:M
Credentials:DAOM, LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2254 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2022
Mailing Address - Country:US
Mailing Address - Phone:408-885-1288
Mailing Address - Fax:
Practice Address - Street 1:2254 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2022
Practice Address - Country:US
Practice Address - Phone:408-885-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-20
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17788171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist