Healthcare Provider Details

I. General information

NPI: 1265597694
Provider Name (Legal Business Name): ROBERTA CHIN KEUNG MPH, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 N EUCLID ST
ANAHEIM CA
92801-1900
US

IV. Provider business mailing address

1188 N EUCLID ST
ANAHEIM CA
92801-1900
US

V. Phone/Fax

Practice location:
  • Phone: 714-254-2708
  • Fax: 714-254-2953
Mailing address:
  • Phone: 714-254-2708
  • Fax: 714-254-2953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: