Provider Demographics
NPI:1215907076
Name:CHENG, EILEEN I-CHUN (OD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:I-CHUN
Last Name:CHENG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 GREGORY LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2800
Mailing Address - Country:US
Mailing Address - Phone:925-687-7638
Mailing Address - Fax:925-687-3079
Practice Address - Street 1:401 GREGORY LN
Practice Address - Street 2:SUITE 110
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2800
Practice Address - Country:US
Practice Address - Phone:925-687-7638
Practice Address - Fax:925-687-3079
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10846T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU81884Medicare UPIN
CASD0108461Medicare ID - Type Unspecified