Healthcare Provider Details

I. General information

NPI: 1194740480
Provider Name (Legal Business Name): BONNIE W. CHEUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CONGRESS ST SUITE 511
PASADENA CA
91105-3045
US

IV. Provider business mailing address

436 ADRIAN CT
CLAREMONT CA
91711-1601
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-0360
  • Fax:
Mailing address:
  • Phone: 216-337-3670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA76760
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35-084868
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number117963
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA76760
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number2023014725
License Number StateMO
# 6
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberU6462
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: