Provider Demographics
NPI:1518163161
Name:CHENG, KAREN DEBORAH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DEBORAH
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 370
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3628
Mailing Address - Country:US
Mailing Address - Phone:949-951-1969
Mailing Address - Fax:949-951-6533
Practice Address - Street 1:24422 AVENIDA DE LA CARLOTA STE 370
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3628
Practice Address - Country:US
Practice Address - Phone:949-951-1969
Practice Address - Fax:949-951-6533
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA893502084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89350OtherCA MEDICAL LICENSE NUMBER