Provider Demographics
NPI:1235457300
Name:CHEUNG, JANNIE W (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JANNIE
Middle Name:W
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 GOLDEN TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-4928
Mailing Address - Country:US
Mailing Address - Phone:562-902-5538
Mailing Address - Fax:562-902-6517
Practice Address - Street 1:15800 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2512
Practice Address - Country:US
Practice Address - Phone:562-902-5538
Practice Address - Fax:562-903-6517
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH45047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist