Healthcare Provider Details

I. General information

NPI: 1528643053
Provider Name (Legal Business Name): JIN QI CHEUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JIN QI

II. Dates (important events)

Enumeration Date: 03/16/2021
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-7201
US

IV. Provider business mailing address

5652 ROSEMEAD BLVD
TEMPLE CITY CA
91780-1800
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2222
  • Fax: 859-323-5090
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number60235
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: