Provider Demographics
NPI:1518007319
Name:CHENG, KWOK FAI GODFREY (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:KWOK FAI
Middle Name:GODFREY
Last Name:CHENG
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CASTRO & DUBOCE SOUTH TOWER LEVEL A
Mailing Address - Street 2:SUITE 160A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-600-6616
Mailing Address - Fax:
Practice Address - Street 1:45 CASTRO ST # A
Practice Address - Street 2:SUITE 160A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1010
Practice Address - Country:US
Practice Address - Phone:415-600-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA612394363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner