Provider Demographics
NPI:1497998777
Name:CHEUNG, ERIC L (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:L
Last Name:CHEUNG
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 1:2301 CIRCADIAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-5444
Mailing Address - Country:US
Mailing Address - Phone:707-526-2027
Mailing Address - Fax:707-526-2096
Practice Address - Street 1:2301 CIRCADIAN WAY
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-5444
Practice Address - Country:US
Practice Address - Phone:707-526-2027
Practice Address - Fax:707-526-2096
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104269174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist