Healthcare Provider Details

I. General information

NPI: 1235592676
Provider Name (Legal Business Name): STEPHEN CHEUNG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2016
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 ARAPAHOE RD
LAFAYETTE CO
80026-8054
US

IV. Provider business mailing address

2970 ARAPAHOE RD
LAFAYETTE CO
80026-8054
US

V. Phone/Fax

Practice location:
  • Phone: 303-460-6010
  • Fax:
Mailing address:
  • Phone: 303-460-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberDR.0063602
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL.0007062
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0063602
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: