Provider Demographics
NPI:1417394883
Name:CHENG, VINCENT (PHARMD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 OWENS ST STE 460
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2335
Mailing Address - Country:US
Mailing Address - Phone:415-514-6145
Mailing Address - Fax:415-514-8395
Practice Address - Street 1:1500 OWENS ST STE 460
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2335
Practice Address - Country:US
Practice Address - Phone:415-514-6145
Practice Address - Fax:415-514-8395
Is Sole Proprietor?:No
Enumeration Date:2013-05-25
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA684901835N1003X
CA68940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support