MEDICARE: CHRISTI CHENG MD INC

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00G772110	OTHER	CA	CALIFORNIA LICENSE

General Provider Information

NPI Number	:	1225187339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTI CHENG MD INC

Provider Business Mailing Address
First Line	:	13851 E 14TH ST STE 102
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2628
Country	:	US
Telephone Number	:	510-351-2100
Fax Number	:	510-357-3389

Provider Business Practice Location Address
First Line	:	13851 E 14TH ST STE 102
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2628
Country	:	US
Telephone Number	:	510-351-2100
Fax Number	:	510-357-3389

Authorized Official
Title or Position	:	BUSINESS OFFICE
Name	:	YVONNE BELL
Credential	:
Telephone Number	:	510-351-2100

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	06/17/2015

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Directions to “CHRISTI CHENG MD INC ” Practice Location

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