Provider Demographics
NPI:1679793673
Name:LAWRENCE C. C. CHEUNG M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:LAWRENCE C. C. CHEUNG M.D. A PROFESSIONAL CORPORATION
Other - Org Name:SYNERGY DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TANSIHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-333-0348
Mailing Address - Street 1:PO BOX 320216
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-0216
Mailing Address - Country:US
Mailing Address - Phone:415-333-0348
Mailing Address - Fax:
Practice Address - Street 1:595 BUCKINGHAM WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1909
Practice Address - Country:US
Practice Address - Phone:415-333-0348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ32639ZMedicare PIN
CAY28049Medicare UPIN