Provider Demographics
NPI:1417002742
Name:CHENG, ALAN JIA (DPT)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JIA
Last Name:CHENG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:13354 SAVANNA STREET
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782
Mailing Address - Country:US
Mailing Address - Phone:562-773-9758
Mailing Address - Fax:714-758-9555
Practice Address - Street 1:2101 W CRESCENT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3806
Practice Address - Country:US
Practice Address - Phone:714-758-9500
Practice Address - Fax:714-758-9555
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT24069BMedicare UPIN