Provider Demographics
NPI:1801015599
Name:POON, PETER PO-KEUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:PO-KEUNG
Last Name:POON
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 1:9817 ARKANSAS ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5913
Mailing Address - Country:US
Mailing Address - Phone:562-867-8881
Mailing Address - Fax:562-867-8821
Practice Address - Street 1:9817 ARKANSAS ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5913
Practice Address - Country:US
Practice Address - Phone:562-867-8881
Practice Address - Fax:562-867-8821
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35568208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA84790Medicare UPIN