Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A80623 | CA |
NPI | 1003857343 |
---|---|
Provider Name | Dr. Ching-Rong Cheng |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103-0801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 28/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A806230 | (05) | CA |
I45148 | (02) |