Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A63141 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | A63141 | CA |
NPI | 1396823357 |
---|---|
Provider Name | Dr. Elbert Cheng |
First Address | Saratoga, CA 95070-4131 |
Second Address | Saratoga, CA 95070-4131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 14/02/2017 |