Provider Demographics
NPI:1912092990
Name:DAVID S. CHENG, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DAVID S. CHENG, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-791-1115
Mailing Address - Street 1:39275 MISSION BLVD
Mailing Address - Street 2:203
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3061
Mailing Address - Country:US
Mailing Address - Phone:510-791-1115
Mailing Address - Fax:510-791-6245
Practice Address - Street 1:39275 MISSION BLVD
Practice Address - Street 2:203
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3061
Practice Address - Country:US
Practice Address - Phone:510-791-1115
Practice Address - Fax:510-791-6245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG247210207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1104892652OtherNPI FOR INDIVIDUAL
CAA42355Medicare UPIN
CA00G247210Medicare ID - Type Unspecified