Provider Demographics
NPI:1831247170
Name:CHEUNG, RAYMOND W M (M D)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:W M
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 S GARFIELD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4768
Mailing Address - Country:US
Mailing Address - Phone:626-282-8387
Mailing Address - Fax:626-282-8392
Practice Address - Street 1:1048 S GARFIELD AVE STE 201
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4768
Practice Address - Country:US
Practice Address - Phone:626-282-8387
Practice Address - Fax:626-282-8392
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60008207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG61413Medicare UPIN
CAWA60008BMedicare ID - Type Unspecified