Provider Demographics
NPI:1407984859
Name:MICHAEL FU CHIROPRACTIC CORP.
Entity Type:Organization
Organization Name:MICHAEL FU CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-588-2101
Mailing Address - Street 1:1300 E MAIN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4149
Mailing Address - Country:US
Mailing Address - Phone:626-588-2101
Mailing Address - Fax:
Practice Address - Street 1:1300 E MAIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4149
Practice Address - Country:US
Practice Address - Phone:626-588-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25694Medicare ID - Type UnspecifiedMEDICARE