Provider Demographics
NPI:1689778003
Name:CHIU, DONALD D (LAC, OMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:D
Last Name:CHIU
Suffix:
Gender:M
Credentials:LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2313
Mailing Address - Country:US
Mailing Address - Phone:415-668-6789
Mailing Address - Fax:415-668-8969
Practice Address - Street 1:323 6TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2313
Practice Address - Country:US
Practice Address - Phone:415-668-6789
Practice Address - Fax:415-668-8969
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1483171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1689778003Medicare PIN