Provider Demographics
NPI:1891018313
Name:CHEUNG, JAMES KYU (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KYU
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 S GAREY AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-3319
Mailing Address - Country:US
Mailing Address - Phone:909-620-8887
Mailing Address - Fax:909-620-8817
Practice Address - Street 1:502 S GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-3319
Practice Address - Country:US
Practice Address - Phone:909-620-8887
Practice Address - Fax:909-620-8817
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25962111N00000X
CAPA20865363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No111N00000XChiropractic ProvidersChiropractor