Basic Information
| Provider Information | |||||||||
| NPI: | 1154983062 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHENG | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6452 ALEXANDRIA DR | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926472524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149086895 | ||||||||
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| Practice Location | |||||||||
| Address1: | 309 W BEVERLY BLVD | ||||||||
| Address2: | |||||||||
| City: | MONTEBELLO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906404308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237261222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2019 | ||||||||
| LastUpdateDate: | 07/01/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 73687 | CA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.