Basic Information
Provider Information
NPI: 1811258163
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHENG
FirstName: ALAUNA
MiddleName: KRISTINE
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11234 ANDERSON ST
Address2: GME OFFICE CSP 21005
City: LOMA LINDA
State: CA
PostalCode: 923542804
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 11234 ANDERSON ST
Address2: GME OFFICE CSP 21005
City: LOMA LINDA
State: CA
PostalCode: 923542804
CountryCode: US
TelephoneNumber: 9095584174
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2012
LastUpdateDate: 11/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0206X20A13183CAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology

No ID Information.


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