Provider Demographics
NPI:1700279718
Name:CHENG, CHRISTINE JOANN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:JOANN
Last Name:CHENG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:JOANN
Other - Last Name:CHIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3972 BARRANCA PKWY STE J216
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1204
Mailing Address - Country:US
Mailing Address - Phone:925-395-3500
Mailing Address - Fax:
Practice Address - Street 1:27785 SANTA MARGARITA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6652
Practice Address - Country:US
Practice Address - Phone:949-670-0199
Practice Address - Fax:949-670-0547
Is Sole Proprietor?:No
Enumeration Date:2015-03-15
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist