Healthcare Provider Details

I. General information

NPI: 1306107560
Provider Name (Legal Business Name): JOHNNY NGUON CHENG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 S CHERRY ST STE 101
DENVER CO
80246-1222
US

IV. Provider business mailing address

469 S CHERRY ST STE 101
DENVER CO
80246-1222
US

V. Phone/Fax

Practice location:
  • Phone: 970-402-4042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number52759
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number52759
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: