Provider Demographics
NPI:1912778937
Name:CHEUNG, LAWRENCE LUKMAN
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:LUKMAN
Last Name:CHEUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 CHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4621
Mailing Address - Country:US
Mailing Address - Phone:510-219-3250
Mailing Address - Fax:
Practice Address - Street 1:20 E RIVER PARK PL W
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1551
Practice Address - Country:US
Practice Address - Phone:510-219-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95203822163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine