Basic Information
| Provider Information | |||||||||
| NPI: | 1942403043 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEUNG | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | LAI | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CDE | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CHEUNG | ||||||||
| OtherFirstName: | LAURIE | ||||||||
| OtherMiddleName: | LAI SOU | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CDE | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 18288 SAGE CT | ||||||||
| Address2: | |||||||||
| City: | SARATOGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950704500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087415510 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 750 S BASCOM AVE | ||||||||
| Address2: | DIABETES ED | ||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951282603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4088855000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD0400X | RN308118 | CA | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No ID Information.