Individual provider Active NPI

Gordon Chih-Jen Cheng, M.D.

  • Pediatrics Physician
  • San Diego, CA
National Provider Identifier
1740540558
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A127844 Issued in CA
Practice address
12036 Scripps Highlands Dr
Ste 102
San Diego, CA 92131-5155
Phone
(858) 566-4444
NPI assigned
May 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A127844 CA Primary

Addresses

Primary practice location

12036 Scripps Highlands Dr
Ste 102
San Diego, CA 92131-5155

Mailing address

12036 Scripps Highlands Dr
Ste 102
San Diego, CA 92131-5155
Phone (858) 566-4444

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

LicenseStateTypeSpecialty
A127844CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Memorial Hospital Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gcheng20553@sharphealthcare.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1337990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1740540558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12036 SCRIPPS HIGHLANDS DR",
            "address_2": "STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921315155",
            "telephone_number": "858-566-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12036 SCRIPPS HIGHLANDS DR",
            "address_2": "STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921315155",
            "telephone_number": "858-566-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "GORDON",
        "middle_name": "CHIH-JEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-26",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A127844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.