Provider Demographics
NPI:1407533599
Name:TENG, CHENGYUN (CHARLOTTE)
Entity Type:Individual
Prefix:
First Name:CHENGYUN (CHARLOTTE)
Middle Name:
Last Name:TENG
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 1:1245 CORONADO DR APT 2
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-5601
Mailing Address - Country:US
Mailing Address - Phone:631-943-4893
Mailing Address - Fax:
Practice Address - Street 1:3626 BALBOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2604
Practice Address - Country:US
Practice Address - Phone:415-223-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program