Healthcare Provider Details

I. General information

NPI: 1376749150
Provider Name (Legal Business Name): WAYNE M CHENG L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 E 17TH ST STE 205
SANTA ANA CA
92701-2641
US

IV. Provider business mailing address

1206 E 17TH ST STE 205
SANTA ANA CA
92701-2641
US

V. Phone/Fax

Practice location:
  • Phone: 714-835-3500
  • Fax: 714-835-4619
Mailing address:
  • Phone: 714-835-3500
  • Fax: 714-835-4619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 7427
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: