Healthcare Provider Details

I. General information

NPI: 1144753468
Provider Name (Legal Business Name): JOYCE CHENG MD, MHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE STE 850
LA JOLLA CA
92037-1233
US

IV. Provider business mailing address

9850 GENESEE AVE STE 850
LA JOLLA CA
92037-1233
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-0267
  • Fax: 858-657-9485
Mailing address:
  • Phone: 858-657-0267
  • Fax: 858-657-9485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA158031
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: