1750669826 NPI number — MR. PETER SIU LAM CHEUNG

Table of content: MR. PETER SIU LAM CHEUNG (NPI 1750669826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750669826 NPI number — MR. PETER SIU LAM CHEUNG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEUNG
Provider First Name:
PETER
Provider Middle Name:
SIU LAM
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750669826
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
01/12/2012
NPI Reactivation Date:
08/27/2014

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15614 WHITTWOOD LN
Provider Second Line Business Mailing Address:
T2019
Provider Business Mailing Address City Name:
WHITTIER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90603-2324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15614 WHITTWOOD LN
Provider Second Line Business Practice Location Address:
T2019
Provider Business Practice Location Address City Name:
WHITTIER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90603-2324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-371-9004
Provider Business Practice Location Address Fax Number:
562-371-9004
Provider Enumeration Date:
07/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  30863 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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