Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 3661 | AZ |
NPI | 1013196922 |
---|---|
Provider Name | Victor Kasing Cheng |
First Address | Glendale, AZ 85308-3546 |
Second Address | Glendale, AZ 85308-3546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 26/10/2007 |