Healthcare Provider Details

I. General information

NPI: 1346009552
Provider Name (Legal Business Name): ALEX CHEAH, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 08/11/2024
Certification Date: 08/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 SAN BERNARDINO RD STE C
UPLAND CA
91786-4980
US

IV. Provider business mailing address

1308 E COLORADO BLVD UNIT 3360
PASADENA CA
91106-1932
US

V. Phone/Fax

Practice location:
  • Phone: 909-981-8985
  • Fax:
Mailing address:
  • Phone: 626-329-1058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ALEXANDER CHEAH
Title or Position: PRESIDENT
Credential: MD
Phone: 909-981-8985