Healthcare Provider Details

I. General information

NPI: 1568467215
Provider Name (Legal Business Name): PHILIP CHEU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2005
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 HARBOR BLVD
COSTA MESA CA
92626-2562
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 714-929-2300
  • Fax: 714-929-2303
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG77212
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: