Healthcare Provider Details

I. General information

NPI: 1730233875
Provider Name (Legal Business Name): KAI YAN CHENG D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL YOKOSUKA JAPAN 82 INAOKACHO
YOKOSUKA JAPAN
2380002
JP

IV. Provider business mailing address

PSC 475 BOX 1
FPO AP
96350-1200
US

V. Phone/Fax

Practice location:
  • Phone: 832-692-3031
  • Fax:
Mailing address:
  • Phone: 832-962-3031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102202277
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: