Provider Demographics
NPI:1053926790
Name:SIU, DARREN (DC)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:SIU
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 1:1550 TECHNOLOGY DR UNIT 1106
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95110-3816
Mailing Address - Country:US
Mailing Address - Phone:408-802-7126
Mailing Address - Fax:
Practice Address - Street 1:1550 TECHNOLOGY DR UNIT 1106
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-3816
Practice Address - Country:US
Practice Address - Phone:408-802-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34521111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition