Healthcare Provider Details

I. General information

NPI: 1518365626
Provider Name (Legal Business Name): DAIJING ZHUANG NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 TRUXTUN AVE STE B
BAKERSFIELD CA
93309-0674
US

IV. Provider business mailing address

6401 TRUXTUN AVE STE B
BAKERSFIELD CA
93309-0674
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-9300
  • Fax: 661-327-9301
Mailing address:
  • Phone: 661-327-9300
  • Fax: 661-327-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95000364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: