Provider Demographics
NPI:1811276181
Name:CHENG, HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
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 1:751 S WEIR CANYON RD
Mailing Address - Street 2:SUITE 167
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1962
Mailing Address - Country:US
Mailing Address - Phone:714-974-0611
Mailing Address - Fax:
Practice Address - Street 1:751 S WEIR CANYON RD
Practice Address - Street 2:SUITE 167
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1962
Practice Address - Country:US
Practice Address - Phone:714-974-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126608207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine