Provider Demographics
NPI:1144606237
Name:CHENG, JENNIFER TRAN (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:TRAN
Last Name:CHENG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:251 W BENCAMP ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3798
Mailing Address - Country:US
Mailing Address - Phone:626-282-3163
Mailing Address - Fax:626-282-2002
Practice Address - Street 1:251 W BENCAMP ST STE A
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3798
Practice Address - Country:US
Practice Address - Phone:626-282-3163
Practice Address - Fax:626-282-2002
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15238152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist