MEDICARE: MARLYN LEE 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	207L00000X	Anesthesiology Physician	A52302	CA

General Provider Information

NPI Number	:	1295842128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLYN LEE CHENG M.D.

Provider Business Mailing Address
First Line	:	1171 S ROBERTSON BLVD # 175
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1403
Country	:	US
Telephone Number	:	310-625-4944
Fax Number	:	310-559-9507

Provider Business Practice Location Address
First Line	:	1171 S ROBERTSON BLVD # 175
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1403
Country	:	US
Telephone Number	:	310-625-4944
Fax Number	:	310-559-9507

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	06/08/2022

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