1659494045 NPI number — DR. CHIENHUNG ROCCO CHENG PH.D.

Table of content: DR. CHIENHUNG ROCCO CHENG PH.D. (NPI 1659494045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659494045 NPI number — DR. CHIENHUNG ROCCO CHENG PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHENG
Provider First Name:
CHIENHUNG
Provider Middle Name:
ROCCO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHENG
Provider Other First Name:
ROCCO
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1659494045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18623 EAST GALE AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDUSTRY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-839-0300
Provider Business Mailing Address Fax Number:
626-839-1780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18623 EAST GALE AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDUSTRY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-839-0300
Provider Business Practice Location Address Fax Number:
626-839-1780
Provider Enumeration Date:
04/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY 14718 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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