Healthcare Provider Details

I. General information

NPI: 1922587195
Provider Name (Legal Business Name): SERENA CHONGLUN ZHOU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S DOBSON RD
MESA AZ
85202-4707
US

IV. Provider business mailing address

901 S DOBSON RD APT 2009
MESA AZ
85202-2962
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-4148
  • Fax:
Mailing address:
  • Phone: 312-363-9775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS023409
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: