Provider Demographics
NPI:1568586170
Name:CHIU, MERCY HUNG (PT)
Entity Type:Individual
Prefix:MRS
First Name:MERCY
Middle Name:HUNG
Last Name:CHIU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:HUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2519 LAS GALLINAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903
Mailing Address - Country:US
Mailing Address - Phone:650-307-3919
Mailing Address - Fax:
Practice Address - Street 1:2519 LAS GALLINAS AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1422
Practice Address - Country:US
Practice Address - Phone:650-307-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28748225100000X
HI2622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist