Healthcare Provider Details

I. General information

NPI: 1831928886
Provider Name (Legal Business Name): ELIOT CHEUK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 W HEMINGWAY BLVD
NAMPA ID
83651-1763
US

IV. Provider business mailing address

PO BOX 261
HEBER CITY UT
84032-0261
US

V. Phone/Fax

Practice location:
  • Phone: 208-505-9990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5281017
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: