Provider Demographics
NPI:1184664377
Name:AU, SHIU CHEONG (MD)
Entity Type:Individual
Prefix:
First Name:SHIU
Middle Name:CHEONG
Last Name:AU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-5318
Mailing Address - Country:US
Mailing Address - Phone:909-593-4333
Mailing Address - Fax:909-593-5588
Practice Address - Street 1:935 S SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3408
Practice Address - Country:US
Practice Address - Phone:626-960-5581
Practice Address - Fax:626-960-0881
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37313174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA28351Medicare UPIN