MEDICARE: DR. DENNIS 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	OPT9221	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49153	OTHER	CA	SAFEGUARD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	6227	OTHER	CA	VSP

General Provider Information

NPI Number	:	1497817886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS CHENG OD

Provider Business Mailing Address
First Line	:	2707 E VALLEY BLVD
Second Line	:	#117
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3195
Country	:	US
Telephone Number	:	626-839-1800
Fax Number	:	626-839-1802

Provider Business Practice Location Address
First Line	:	2707 E VALLEY BLVD
Second Line	:	#117
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3195
Country	:	US
Telephone Number	:	626-839-1800
Fax Number	:	626-839-1802

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	10/17/2011

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