Provider Demographics
NPI:1558372649
Name:HSIEH, CHENG K (MD)
Entity Type:Individual
Prefix:
First Name:CHENG
Middle Name:K
Last Name:HSIEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15366 11TH ST
Mailing Address - Street 2:SUITE N
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3726
Mailing Address - Country:US
Mailing Address - Phone:760-243-5699
Mailing Address - Fax:760-243-7091
Practice Address - Street 1:15366 11TH ST
Practice Address - Street 2:SUITE N
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3726
Practice Address - Country:US
Practice Address - Phone:760-243-5699
Practice Address - Fax:760-243-7091
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC38334207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C383340Medicare ID - Type Unspecified
CAA36902Medicare UPIN