Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 20A12483 | CA |
NPI | 1003109513 |
---|---|
Provider Name | Michael Cheng |
First Address | Chino Hills, CA 91709-4584 |
Second Address | Orange, CA 92868-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2011 |
Last Update Date | 28/06/2019 |