Provider Demographics
NPI:1730637729
Name:CHEUNG, AINSLIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AINSLIE
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 PENTLAND ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3842
Mailing Address - Country:US
Mailing Address - Phone:858-717-7169
Mailing Address - Fax:
Practice Address - Street 1:127 S SAN VICENTE BLVD
Practice Address - Street 2:SUITE 2403
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3311
Practice Address - Country:US
Practice Address - Phone:424-315-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist