MEDICARE: CHENG K HSIEH 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	207V00000X	Obstetrics & Gynecology Physician	C38334	CA

General Provider Information

NPI Number	:	1558372649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHENG K HSIEH M.D.

Provider Business Mailing Address
First Line	:	15366 11TH ST
Second Line	:	SUITE N
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	760-243-5699
Fax Number	:	760-243-7091

Provider Business Practice Location Address
First Line	:	15366 11TH ST
Second Line	:	SUITE N
City	:	VICTORVILLE
State	:	CA
Zip	:	92395-3726
Country	:	US
Telephone Number	:	760-243-5699
Fax Number	:	760-243-7091

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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