Healthcare Provider Details

I. General information

NPI: 1598817132
Provider Name (Legal Business Name): ERIC CHEUNG PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S MAIN ST
WALNUT CREEK CA
94596-5318
US

IV. Provider business mailing address

1451 34TH AVE
SAN FRANCISCO CA
94122-3148
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-4655
  • Fax:
Mailing address:
  • Phone: 415-412-7657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number57487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: