Healthcare Provider Details

I. General information

NPI: 1538600887
Provider Name (Legal Business Name): JONATHAN HIN CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2017
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S GRAND AVE STE 800
LOS ANGELES CA
90015-3048
US

IV. Provider business mailing address

1400 S GRAND AVE STE 800
LOS ANGELES CA
90015-3048
US

V. Phone/Fax

Practice location:
  • Phone: 213-748-1414
  • Fax:
Mailing address:
  • Phone: 213-748-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA157528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: