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NPI Code Detail

MEDICARE: TIYU ISABELLA CHENG

MEDICARE: TIYU ISABELLA CHENG
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
1390200000XStudent in an Organized Health Care Education/Training Program
2363A00000XPhysician Assistant8653-23WI

Other Identifiers

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

General Provider Information

NPI Number : 1932957115
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIYU ISABELLA CHENG
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 1800 NOVELL PL
Second Line :
City : PROVO
State : UT
Zip : 84606-6171
Country : US
Telephone Number : 612-600-1464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2024
Last Update Date : 03/12/2026

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Directions to “ TIYU ISABELLA CHENG ” Practice Location

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