Provider Demographics
NPI:1508079914
Name:CHENG, WENDY WONG (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:WONG
Last Name:CHENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:WEN-HAI
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:99 N LA CIENEGA BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2222
Mailing Address - Country:US
Mailing Address - Phone:310-657-9841
Mailing Address - Fax:310-657-9893
Practice Address - Street 1:99 N LA CIENEGA BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2222
Practice Address - Country:US
Practice Address - Phone:310-657-9841
Practice Address - Fax:310-657-9893
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine