Healthcare Provider Details

I. General information

NPI: 1750437745
Provider Name (Legal Business Name): GEORGE C CHENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W PUEBLO ST
SANTA BARBARA CA
93105-4311
US

IV. Provider business mailing address

SANSUM CLINIC PO BOX 62106
SANTA BARBARA CA
93106-2106
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7300
  • Fax: 805-898-3607
Mailing address:
  • Phone: 805-682-7300
  • Fax: 805-898-3607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG87213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: