Provider Demographics
NPI:1225129711
Name:CHU, TONY W (DC)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:W
Last Name:CHU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23767 SUNNYMEAD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-7750
Mailing Address - Country:US
Mailing Address - Phone:951-924-0967
Mailing Address - Fax:951-924-3436
Practice Address - Street 1:23767 SUNNYMEAD BLVD STE A
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-7750
Practice Address - Country:US
Practice Address - Phone:951-924-0967
Practice Address - Fax:951-924-3436
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor