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General NPI Number Information
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NPI Number | 1548352800
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Entity Type | Individual
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Provider Name | JIYON CHENG O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 10250 BALTIMORE AVE SUITE C
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City | COLLEGE PARK
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State | MD
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Zip | 20740-4202
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Country | US
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Telephone | 301-614-0859
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Fax | 301-474-3086
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Provider Business Mailing Address
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Address Line | 2101 E JEFFERSON ST KAISER PERMANENTE ENROLLMENT
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City | ROCKVILLE
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State | MD
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Zip | 20852-4908
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Country | US
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Telephone | 301-816-2424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1820
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License Number State | MD
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