Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A9544 | CA |
N | 2081P2900X | Pain Medicine | 20A9544 | CA |
N | 2081S0010X | Sports Medicine | 20A9544 | CA |
N | 213ES0000X | Sports Medicine | 20A9544 | CA |
NPI | 1457558595 |
---|---|
Provider Name | Ernest Yadao Cheng |
First Address | Berkeley, CA 94705 |
Second Address | Berkeley, CA 94705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 01/04/2014 |