Healthcare Provider Details

I. General information

NPI: 1720510928
Provider Name (Legal Business Name): YING CHIA CHENG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4270 S DECATUR BLVD STE B6
LAS VEGAS NV
89103
US

IV. Provider business mailing address

4270 S DECATUR BLVD STE B6
LAS VEGAS NV
89103-6802
US

V. Phone/Fax

Practice location:
  • Phone: 702-485-2100
  • Fax: 702-947-5352
Mailing address:
  • Phone: 702-485-2100
  • Fax: 702-947-5352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDO1948
License Number StateNV

VIII. Authorized Official

Name: DR. YING CHIA CHENG
Title or Position: PROVIDER
Credential: DO
Phone: 702-485-2100