Provider Demographics
NPI:1124001821
Name:CHENG, YA-WEN (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:YA-WEN
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:DC, LAC
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 1680
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-7680
Mailing Address - Country:US
Mailing Address - Phone:626-292-6899
Mailing Address - Fax:626-286-7226
Practice Address - Street 1:612 WEST DUARTE ROAD
Practice Address - Street 2:SUITE 801
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9248
Practice Address - Country:US
Practice Address - Phone:626-292-6899
Practice Address - Fax:626-286-7226
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27401111N00000X
CAAC8610171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27401Medicare ID - Type Unspecified