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General NPI Number Information
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NPI Number | 1659592632
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Entity Type | Individual
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Provider Name | RENNIE CHEUNG D.M.D., M.D
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11550 INDIAN HILLS RD STE # 320
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City | MISSION HILLS
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State | CA
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Zip | 91345-1200
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Country | US
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Telephone | 818-365-0817
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Fax | 818-365-0578
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Provider Business Mailing Address
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Address Line | 11550 INDIAN HILLS RD STE # 320
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City | MISSION HILLS
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State | CA
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Zip | 91345-1200
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Country | US
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Telephone | 818-365-0817
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Fax | 818-365-0578
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 47864
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License Number State | CA
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