MEDICARE: DR. CHRISTI C CHENG MD

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	6077211	CA

General Provider Information

NPI Number	:	1982674685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTI C CHENG MD

Provider Business Mailing Address
First Line	:	PO BOX 3888
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-8888
Country	:	US
Telephone Number	:	925-718-6622
Fax Number	:

Provider Business Practice Location Address
First Line	:	13847 E 14TH ST
Second Line	:	STE 108
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2632
Country	:	US
Telephone Number	:	510-912-0105
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	03/22/2016

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