MEDICARE: YVETTE ELIZABETH CHENG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	066724	CA

General Provider Information

NPI Number	:	1104298413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE ELIZABETH CHENG

Provider Business Mailing Address
First Line	:	3644 E OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-3129
Country	:	US
Telephone Number	:	323-264-0496
Fax Number	:	323-264-6589

Provider Business Practice Location Address
First Line	:	3644 E OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-3129
Country	:	US
Telephone Number	:	323-264-0496
Fax Number	:	323-264-6589

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	10/26/2015

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