Provider Demographics
NPI:1508891490
Name:CHU, EDWARD YI TER (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:YI TER
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 1:16404 COLIMA RD FL 1
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5502
Mailing Address - Country:US
Mailing Address - Phone:626-581-7603
Mailing Address - Fax:626-581-8411
Practice Address - Street 1:16404 COLIMA RD FL 1
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-5502
Practice Address - Country:US
Practice Address - Phone:626-581-7603
Practice Address - Fax:626-581-8411
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU82800Medicare UPIN
CADC26853Medicare PIN