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General NPI Number Information
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NPI Number | 1336671981
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Entity Type | Individual
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Provider Name | DEREK CHEUNG MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 01/22/2022
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Provider Practice Location Address
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Address Line | 375 HUNTINGTON DR STE G
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City | SAN MARINO
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State | CA
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Zip | 91108-2357
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Country | US
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Telephone | 626-441-4231
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Fax |
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Provider Business Mailing Address
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Address Line | 229 FLORENCE AVE
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City | MONTEREY PARK
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State | CA
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Zip | 91755-2075
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Country | US
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Telephone | 661-609-2978
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A158438
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License Number State | CA
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