Healthcare Provider Details

I. General information

NPI: 1255763553
Provider Name (Legal Business Name): KATHY CHENG ZHANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12244 W CACTUS RD
EL MIRAGE AZ
85335-2399
US

IV. Provider business mailing address

12244 W CACTUS RD
EL MIRAGE AZ
85335-2399
US

V. Phone/Fax

Practice location:
  • Phone: 623-876-1620
  • Fax:
Mailing address:
  • Phone: 623-876-1620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS020007
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: