MEDICARE: DAVID S. CHENG, M.D. A PROFESSIONAL CORPORATION

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	207RH0003X	Hematology & Oncology Physician	G247210	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1104892652	OTHER	CA	NPI FOR INDIVIDUAL

General Provider Information

NPI Number	:	1912092990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID S. CHENG, M.D. A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	39275 MISSION BLVD
Second Line	:	203
City	:	FREMONT
State	:	CA
Zip	:	94539-3061
Country	:	US
Telephone Number	:	510-791-1115
Fax Number	:	510-791-6245

Provider Business Practice Location Address
First Line	:	39275 MISSION BLVD
Second Line	:	203
City	:	FREMONT
State	:	CA
Zip	:	94539-3061
Country	:	US
Telephone Number	:	510-791-1115
Fax Number	:	510-791-6245

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID S CHENG
Credential	:	M.D
Telephone Number	:	510-791-1115

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	01/31/2008

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