Healthcare Provider Details

I. General information

NPI: 1205482627
Provider Name (Legal Business Name): ERIC CHENG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 NORTH GRAND BOULEVARD
SAINT LOUIS MO
63106-1621
US

IV. Provider business mailing address

4826 GEARY BLVD # 2
SAN FRANCISCO CA
94118-2911
US

V. Phone/Fax

Practice location:
  • Phone: 301-518-0527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP451858
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: