Provider Demographics
NPI:1013196922
Name:CHENG, VICTOR KASING (DO)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:KASING
Last Name:CHENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 W BELL RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3546
Mailing Address - Country:US
Mailing Address - Phone:602-978-3545
Mailing Address - Fax:602-978-2649
Practice Address - Street 1:4334 W BELL RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3546
Practice Address - Country:US
Practice Address - Phone:602-978-3545
Practice Address - Fax:602-978-2649
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3661156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3472690001Medicare NSC