Provider Demographics
NPI:1588971139
Name:CHENG, CHRISTINE M (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:CHENG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 PARNASSUS AVE
Mailing Address - Street 2:C-152 BOX 0622
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0622
Mailing Address - Country:US
Mailing Address - Phone:415-476-0220
Mailing Address - Fax:415-476-6632
Practice Address - Street 1:521 PARNASSUS AVE
Practice Address - Street 2:C-152 BOX 0622
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0622
Practice Address - Country:US
Practice Address - Phone:415-476-0220
Practice Address - Fax:415-476-6632
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH51321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist