MEDICARE: ANGELA C. CHENG M.D.

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	2084P0800X	Psychiatry Physician	A78773	CA

General Provider Information

NPI Number	:	1154373066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA C. CHENG M.D.

Provider Business Mailing Address
First Line	:	1499 HUNTINGTON DR
Second Line	:	SUITE 318
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4552
Country	:	US
Telephone Number	:	626-823-0450
Fax Number	:	626-403-6440

Provider Business Practice Location Address
First Line	:	1499 HUNTINGTON DR
Second Line	:	SUITE 318
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4552
Country	:	US
Telephone Number	:	626-823-0450
Fax Number	:	626-403-6440

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	03/22/2010

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