Healthcare Provider Details

I. General information

NPI: 1710802442
Provider Name (Legal Business Name): CHENG HUA JIANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

3097 MOORPARK AVE STE 100
SAN JOSE CA
95128-2543
US

IV. Provider business mailing address

300 WINSTON DR APT 316
CLIFFSIDE PARK NJ
07010-3210
US

V. Phone/Fax

Practice location:
  • Phone: 669-247-6170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: