Provider Demographics
NPI:1578834891
Name:CHEUNG, JOHN K (LAC, MSOM)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:K
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:LAC, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 HUNTINGTON DR STE 330
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-2451
Mailing Address - Country:US
Mailing Address - Phone:626-780-3015
Mailing Address - Fax:
Practice Address - Street 1:601 N AVALON BLVD STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5871
Practice Address - Country:US
Practice Address - Phone:818-940-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14318171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist