Basic Information
Provider Information
NPI: 1427546670
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEUNG
FirstName: BRIAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 S MANCHESTER AVE STE 300
Address2:  
City: ORANGE
State: CA
PostalCode: 928683219
CountryCode: US
TelephoneNumber: 7144562986
FaxNumber:  
Practice Location
Address1: 2161 SAN JOAQUIN HILLS RD
Address2:  
City: NEWPORT BEACH
State: CA
PostalCode: 926606507
CountryCode: US
TelephoneNumber: 9493865700
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/24/2018
LastUpdateDate: 11/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA179658CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home