Provider Demographics
NPI:1740386705
Name:YEH, CHENG TSUNG (MD)
Entity Type:Individual
Prefix:MR
First Name:CHENG
Middle Name:TSUNG
Last Name:YEH
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 1:925 W DUARTE RD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-4306
Mailing Address - Country:US
Mailing Address - Phone:626-821-8770
Mailing Address - Fax:626-821-8681
Practice Address - Street 1:925 W DUARTE RD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-4306
Practice Address - Country:US
Practice Address - Phone:626-821-8770
Practice Address - Fax:626-821-8681
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA254530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A254530Medicaid
CA00A254530Medicaid
00A254530Medicare ID - Type Unspecified