Provider Demographics
NPI:1679587711
Name:HER, PO CHUA (DC)
Entity type:Individual
Prefix:DR
First Name:PO
Middle Name:CHUA
Last Name:HER
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 1:75 W MARCH LN STE J
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5729
Mailing Address - Country:US
Mailing Address - Phone:209-474-1330
Mailing Address - Fax:209-474-7859
Practice Address - Street 1:75 W MARCH LN STE J
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5729
Practice Address - Country:US
Practice Address - Phone:209-474-1330
Practice Address - Fax:209-474-7859
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor