Provider Demographics
NPI:1962468793
Name:CHENG, SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
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:PO BOX 45731
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94145-0731
Mailing Address - Country:US
Mailing Address - Phone:858-244-0115
Mailing Address - Fax:858-244-0153
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:ANESTHESIOLOGY
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-428-3070
Practice Address - Fax:510-450-5853
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84624207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G846240Medicaid
F67391Medicare UPIN
CA00G846240Medicare PIN