Provider Demographics
NPI:1740653682
Name:CHENG, CHING-CHI (PHARMD)
Entity type:Individual
Prefix:
First Name:CHING-CHI
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-8728
Mailing Address - Country:US
Mailing Address - Phone:916-996-7817
Mailing Address - Fax:
Practice Address - Street 1:12101 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2421
Practice Address - Country:US
Practice Address - Phone:909-591-3911
Practice Address - Fax:909-591-5823
Is Sole Proprietor?:No
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist