MEDICARE: JASON J 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	207Q00000X	Family Medicine Physician	33528	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538129200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON J CHENG M.D.

Provider Business Mailing Address
First Line	:	1441 N 12TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2837
Country	:	US
Telephone Number	:	602-495-4577
Fax Number	:	602-417-3549

Provider Business Practice Location Address
First Line	:	3336 E CHANDLER HEIGHTS RD
Second Line	:	BLDG. 1, SUITE 101
City	:	GILBERT
State	:	AZ
Zip	:	85298-4259
Country	:	US
Telephone Number	:	480-412-5900
Fax Number	:	480-890-2997

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

Provider Enumeration Date	:	03/25/2006
Last Update Date	:	12/05/2011

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Directions to “ JASON J CHENG M.D.” Practice Location

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