Provider Demographics
NPI:1528240926
Name:CHEANG, VICTOR LEON (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:LEON
Last Name:CHEANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5321 VIA MARISOL
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4883
Mailing Address - Country:US
Mailing Address - Phone:323-545-8090
Mailing Address - Fax:323-344-8829
Practice Address - Street 1:5321 VIA MARISOL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4883
Practice Address - Country:US
Practice Address - Phone:323-545-8090
Practice Address - Fax:323-344-8829
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1016552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHH860ZMedicare PIN
CAHH860YMedicare PIN