Derek Cheung, MD
Individual provider Active NPI Internal Medicine Physician · San Marino, CA
NPI 1336671981 · NPPES record last updated Jan 22, 2022
Key facts
- NPI
- 1336671981
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A158438 (CA)
- Practice address
- 375 Huntington Dr Ste G
San Marino, CA 91108-2357 - Phone
- (626) 441-4231
- NPI assigned
- Apr 3, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201001000404 | CA | Practitioner - Internal Medicine | 1759700354 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A158438 | CA | MD | Internal Medicine Physician |
Practice roles (7 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Northeast Valley Health Corporation | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Northeast Valley Health Corporation | Current |
Accepting new patients | |
| Northeast Valley Health Corporation | Current | Accepting new patients | |
| The Huntington Medical Foundation | Internal Medicine | Current |
Accepting new patients |
Locations
4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784
4867 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 783-7920
7843 Lankershim Blvd
North Hollywood, CA 91605
Phone (818) 765-8656
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
65 N Madison Ave
Ste 800
Pasadena, CA 91101
Phone (626) 792-3141
10 Congress St
Ste 208
Pasadena, CA 91105
Phone (626) 792-2166
1172 N Maclay Ave
San Fernando, CA 91340
Phone (818) 898-1388
1600 San Fernando Rd
San Fernando, CA 91340
Phone (818) 365-8086
375 Huntington Dr
Ste G
San Marino, CA 91108
Phone (626) 441-4231
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- derek.cheung.p1@direct.cscla.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A158438 | CA | Yes |
Addresses
Primary practice location
375 Huntington Dr Ste G
San Marino, CA 91108-2357
Mailing address
229 Florence Ave
Monterey Park, CA 91755-2075
Phone (661) 609-2978
Other providers in San Marino, CA
- Diana Chang
- Wayne H Chang
- Daniel Chee
- Sonya Chen-Hsieh
- Chen I Chen
- Mu-Chien Chiang
- Desmond B. Chiong
- Chien-CHI Chiu
- Linus Chong
- Warren Ritchie Christianson II
All providers in San Marino, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.