Healthcare Provider Details

I. General information

NPI: 1013442896
Provider Name (Legal Business Name): MICHAEL ALEXANDER CHENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST # 8
TORRANCE CA
90502
US

IV. Provider business mailing address

1000 W CARSON ST # 8
TORRANCE CA
90502-2004
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-7791
  • Fax: 310-320-6973
Mailing address:
  • Phone: 310-222-3151
  • Fax: 310-328-7217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA156836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: