Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A046213 | CA |
NPI | 1073619706 |
---|---|
Provider Name | Dr. Paul P Cheng |
First Address | San Leandro, CA 94577-4915 |
Second Address | San Leandro, CA 94577-4915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 30/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F61729 | (02) |