Provider Demographics
NPI:1720963564
Name:CHEUNG, KEITH
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
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 1:3241 MARLENE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4723
Mailing Address - Country:US
Mailing Address - Phone:925-984-3471
Mailing Address - Fax:
Practice Address - Street 1:3241 MARLENE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4723
Practice Address - Country:US
Practice Address - Phone:925-984-3471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist