Provider Demographics
NPI:1265987523
Name:CHENG, CHI (PHARMD)
Entity type:Individual
Prefix:
First Name:CHI
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 E BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1703
Mailing Address - Country:US
Mailing Address - Phone:323-264-5060
Mailing Address - Fax:323-264-5252
Practice Address - Street 1:5119 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1703
Practice Address - Country:US
Practice Address - Phone:323-264-5060
Practice Address - Fax:323-264-5252
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist