Individual provider Active NPI

Ivy Ya Wen Cheng, PHARMD

  • Pharmacist
  • Alta Loma, CA
National Provider Identifier
1487921334
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52885 Issued in CA
Practice address
6701 Carnelian St
Alta Loma, CA 91701-4556
Phone
(909) 581-1157
NPI assigned
Nov 21, 2011
Last updated
Nov 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 52885 CA Primary

Addresses

Primary practice location

6701 Carnelian St
Alta Loma, CA 91701-4556

Mailing address

6701 Carnelian St
Alta Loma, CA 91701-4556
Phone (909) 581-1157

Other identifiers 1

IdentifierTypeStateIssuer
52885OtherCAPHARMACIST LICENSE NUMBER

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
52885CAMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1487921334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 CARNELIAN ST",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917014556",
            "telephone_number": "909-581-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 CARNELIAN ST",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917014556",
            "telephone_number": "909-581-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "IVY",
        "middle_name": "YA WEN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "52885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "52885",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alta Loma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.