Provider Demographics
NPI:1558105734
Name:MARK CHEUNG, O.D., P.C.
Entity type:Organization
Organization Name:MARK CHEUNG, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:MINGTAK
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:661-545-1684
Mailing Address - Street 1:136 ALLEN RD
Mailing Address - Street 2:STE 100-1008PC
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314
Mailing Address - Country:US
Mailing Address - Phone:661-545-1684
Mailing Address - Fax:
Practice Address - Street 1:12716 STOCKDALE HWY STE 400
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-3717
Practice Address - Country:US
Practice Address - Phone:661-545-1684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty