Provider Demographics
NPI:1215033824
Name:CHU & CHU CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CHU & CHU CHIROPRACTIC, INC.
Other - Org Name:VITAL CHIROPRACTIC GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-595-1124
Mailing Address - Street 1:21349 COLD SPRING LN
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3443
Mailing Address - Country:US
Mailing Address - Phone:909-595-1124
Mailing Address - Fax:909-595-1146
Practice Address - Street 1:21349 COLD SPRING LN
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-3443
Practice Address - Country:US
Practice Address - Phone:909-595-1124
Practice Address - Fax:909-595-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21922111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty