MEDICARE: SHIH-KANG CHENG RDCS,RVT, RDMS

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	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1699264309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIH-KANG CHENG RDCS,RVT, RDMS

Provider Business Mailing Address
First Line	:	6359 SAN RUFO CIR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-3639
Country	:	US
Telephone Number	:	720-660-5293
Fax Number	:	877-436-3472

Provider Business Practice Location Address
First Line	:	6359 SAN RUFO CIR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-3639
Country	:	US
Telephone Number	:	720-660-5293
Fax Number	:	877-436-3472

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

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	05/08/2018

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