Basic Information
Provider Information
NPI: 1366612228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHENG
FirstName: RODNEY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 225 S LAKE AVE STE 535
Address2:  
City: PASADENA
State: CA
PostalCode: 911013010
CountryCode: US
TelephoneNumber: 6267956596
FaxNumber: 6267958247
Practice Location
Address1: 1420 S CENTRAL AVE
Address2: DEPT OF ANESTHESIOLOGY
City: GLENDALE
State: CA
PostalCode: 912042508
CountryCode: US
TelephoneNumber: 8185021900
FaxNumber: 8185024738
Other Information
ProviderEnumerationDate: 03/06/2008
LastUpdateDate: 02/09/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA94596CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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