MEDICARE: BRADFORD CHEUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1790178259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADFORD CHEUNG

Provider Business Mailing Address
First Line	:	105 LOYOLA PLZ
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-2514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 E 7TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-4503
Country	:	US
Telephone Number	:	562-508-2449
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	03/09/2015

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Directions to “ BRADFORD CHEUNG ” Practice Location

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