Provider Demographics
NPI:1396823357
Name:CHENG, ELBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ELBERT
Middle Name:
Last Name:CHENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12945 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4131
Mailing Address - Country:US
Mailing Address - Phone:408-255-3223
Mailing Address - Fax:408-255-3957
Practice Address - Street 1:12945 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4131
Practice Address - Country:US
Practice Address - Phone:408-255-3223
Practice Address - Fax:408-255-3957
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63141174400000X, 207YS0123X, 207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No174400000XOther Service ProvidersSpecialist
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck