Provider Demographics
NPI:1164672358
Name:CHENG' S MEDICAL CENTER - PRC
Entity Type:Organization
Organization Name:CHENG' S MEDICAL CENTER - PRC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XIAOHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-581-7898
Mailing Address - Street 1:19237 E. COLIMA RD.
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3055
Mailing Address - Country:US
Mailing Address - Phone:626-581-7898
Mailing Address - Fax:626-581-3018
Practice Address - Street 1:416 W. LAS TUNAS DR. #201
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1236
Practice Address - Country:US
Practice Address - Phone:626-289-8598
Practice Address - Fax:626-289-8278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5608171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty