Healthcare Provider Details

I. General information

NPI: 1205586773
Provider Name (Legal Business Name): JOHN YU CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STEIN PLZ
LOS ANGELES CA
90095-7065
US

IV. Provider business mailing address

757 WESTWOOD PLZ RM B713
LOS ANGELES CA
90095-8358
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-5000
  • Fax: 310-825-9426
Mailing address:
  • Phone: 310-825-8307
  • Fax: 310-267-3643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA187287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: