Active NPI
Julie C Cheng, M.D.
- Pediatrics Physician
- Fountain Valley, CA
National Provider Identifier
1225110968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A79108
- Practice address
- 15975 Harbor Blvd
Fountain Valley, CA 92708-1303 - Phone
- (714) 546-6575
- Fax
- (714) 551-9411
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A79108 | CA | Primary |
Addresses
Primary practice location
15975 Harbor Blvd
Fountain Valley, CA 92708-1303
Mailing address
2 Oakdale
Irvine, CA 92604-3221
Phone (714) 546-6575
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0061200 | Medicaid | CA | |
| 00A791080 | Medicaid | CA | |
| GR0061190 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A79108 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Kids, a Professional Medical Corporation | Pediatrics | Past | Accepting new patients |
| South Coast Global Medical Center, Inc | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Newport Beach, CA
- NPI 1740311737
-
- General Acute Care Hospital
- Santa Ana, CA
- NPI 1558354258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483574400000",
"number": "1225110968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 OAKDALE",
"city": "IRVINE",
"state": "CA",
"postal_code": "926043221",
"telephone_number": "714-546-6575",
"fax_number": "714-551-9411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15975 HARBOR BLVD",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927081303",
"telephone_number": "714-546-6575",
"fax_number": "714-551-9411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENG",
"first_name": "JULIE",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2017-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A79108",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0061200",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A791080",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0061190",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.