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General NPI Number Information
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NPI Number | 1770608069
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Entity Type | Organization
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Legal Business Name | JEAN CHENG, M.D. INC.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 8990 GARFIELD ST STE 1 AND 2
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City | RIVERSIDE
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State | CA
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Zip | 92503-3922
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Country | US
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Telephone | 951-785-5421
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Fax | 951-785-0130
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Provider Business Mailing Address
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Address Line | 8990 GARFIELD ST STE 1 AND 2
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City | RIVERSIDE
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State | CA
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Zip | 92503-3922
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Country | US
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Telephone | 951-785-5421
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Fax | 951-785-0130
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEAN CHENG
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Credential | M.D.
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Telephone | 951-785-5421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A60710
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License Number State | CA
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