Provider Demographics
NPI:1477648335
Name:LEW, MICHELLE CHEUNG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CHEUNG
Last Name:LEW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:CHEUNG
Other - Last Name:LEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:77 TRAILWOOD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1257
Mailing Address - Country:US
Mailing Address - Phone:949-390-7280
Mailing Address - Fax:
Practice Address - Street 1:351 EAST TEMPLE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:213-253-2677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 494021835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist