MEDICARE: CHI CHENG PHARMD

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	55871	CA

General Provider Information

NPI Number	:	1265987523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHI CHENG PHARMD

Provider Business Mailing Address
First Line	:	5119 E BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1703
Country	:	US
Telephone Number	:	323-264-5060
Fax Number	:	323-264-5252

Provider Business Practice Location Address
First Line	:	5119 E BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1703
Country	:	US
Telephone Number	:	323-264-5060
Fax Number	:	323-264-5252

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

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/16/2016

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Directions to “ CHI CHENG PHARMD” Practice Location

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