Provider Demographics
NPI:1801229281
Name:FU, JIM (DC)
Entity Type:Individual
Prefix:DR
First Name:JIM
Middle Name:
Last Name:FU
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 1:391 SUTTER ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4303
Mailing Address - Country:US
Mailing Address - Phone:415-788-2298
Mailing Address - Fax:415-552-5056
Practice Address - Street 1:391 SUTTER ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4303
Practice Address - Country:US
Practice Address - Phone:415-788-2298
Practice Address - Fax:415-552-5056
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor