MEDICARE: JASPER CHENG OD

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	152W00000X	Optometrist	34886	CA

General Provider Information

NPI Number	:	1457024721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASPER CHENG OD

Provider Business Mailing Address
First Line	:	51 GOLDEN GLEN ST
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92604-2455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8519 IRVINE CENTER DR
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-4298
Country	:	US
Telephone Number	:	949-585-9403
Fax Number	:

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

Provider Enumeration Date	:	07/31/2021
Last Update Date	:	07/31/2021

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Directions to “ JASPER CHENG OD” Practice Location

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