Provider Demographics
NPI:1689741290
Name:CHEUNG, KAM YUEN (MD)
Entity Type:Individual
Prefix:
First Name:KAM
Middle Name:YUEN
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KAM
Other - Middle Name:Y
Other - Last Name:CHEUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:638 WEBSTER ST.
Mailing Address - Street 2:SUITE 328
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4126
Mailing Address - Country:US
Mailing Address - Phone:510-268-9888
Mailing Address - Fax:510-268-9892
Practice Address - Street 1:638 WEBSTER ST.
Practice Address - Street 2:SUITE 328
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4126
Practice Address - Country:US
Practice Address - Phone:510-268-9888
Practice Address - Fax:510-268-9892
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49444208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A494441Medicaid
CA00A494441Medicaid
00A494440Medicare PIN