Provider Demographics
NPI:1073151536
Name:CHRISTINE A. CHENG MD PC
Entity Type:Organization
Organization Name:CHRISTINE A. CHENG MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-298-9774
Mailing Address - Street 1:415 MEDICAL DR STE D102
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8906
Mailing Address - Country:US
Mailing Address - Phone:801-298-9774
Mailing Address - Fax:801-298-9611
Practice Address - Street 1:415 MEDICAL DR STE D102
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-8906
Practice Address - Country:US
Practice Address - Phone:801-298-9774
Practice Address - Fax:801-298-9611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty