Provider Demographics
NPI:1194179747
Name:CHENG, CHRISTINA
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SW LONGVIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2116
Mailing Address - Country:US
Mailing Address - Phone:816-477-7200
Mailing Address - Fax:877-384-3106
Practice Address - Street 1:400 SW LONGVIEW BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2116
Practice Address - Country:US
Practice Address - Phone:816-477-7200
Practice Address - Fax:877-384-3106
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS390200000X
KS04-43924207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine