Provider Demographics
NPI:1306211842
Name:TIAN YUN CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:TIAN YUN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-728-3285
Mailing Address - Street 1:1752 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2321
Mailing Address - Country:US
Mailing Address - Phone:415-728-3285
Mailing Address - Fax:415-520-9168
Practice Address - Street 1:1752 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2321
Practice Address - Country:US
Practice Address - Phone:415-728-3285
Practice Address - Fax:415-520-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty