Healthcare Provider Details

I. General information

NPI: 1164683389
Provider Name (Legal Business Name): LEI ZHANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

IV. Provider business mailing address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1450
  • Fax:
Mailing address:
  • Phone: 714-774-1450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA117993
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA117993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: