Provider Demographics
NPI:1689873408
Name:CHENG, GABRIEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:K
Last Name:CHENG
Suffix:
Gender:M
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:PO BOX 17098
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92817-7098
Mailing Address - Country:US
Mailing Address - Phone:562-683-1317
Mailing Address - Fax:
Practice Address - Street 1:5505 E SANTA ANA CANYON RD
Practice Address - Street 2:# 17098
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92817-9700
Practice Address - Country:US
Practice Address - Phone:562-683-1317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC326762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology