Provider Demographics
NPI:1457558595
Name:CHENG, ERNEST YADAO (DO)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:YADAO
Last Name:CHENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 TELEGRAPH AVE.
Mailing Address - Street 2:STE. 241
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705
Mailing Address - Country:US
Mailing Address - Phone:510-549-2038
Mailing Address - Fax:510-549-2690
Practice Address - Street 1:3031 TELEGRAPH AVE.
Practice Address - Street 2:STE. 241
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-549-2038
Practice Address - Fax:510-549-2690
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9544208100000X, 2081P2900X, 208VP0014X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine