Healthcare Provider Details

I. General information

NPI: 1215181722
Provider Name (Legal Business Name): CHENG-HAN CHEN M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24022 CALLE DE LA PLATA STE 500
LAGUNA HILLS CA
92653-7612
US

IV. Provider business mailing address

35 CREEK RD
IRVINE CA
92604-4724
US

V. Phone/Fax

Practice location:
  • Phone: 877-430-7337
  • Fax: 714-445-0245
Mailing address:
  • Phone: 714-445-0220
  • Fax: 714-445-0245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA110621
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA110621
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberA110621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: