Healthcare Provider Details

I. General information

NPI: 1487032900
Provider Name (Legal Business Name): APOLLO FAMILY MEDICINE AND SLEEP MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2015
Last Update Date: 05/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 EL CAMINO REAL SUITE 507
BURLINGAME CA
94010-3103
US

IV. Provider business mailing address

PO BOX 8221
FOSTER CITY CA
94404-8221
US

V. Phone/Fax

Practice location:
  • Phone: 650-697-4195
  • Fax:
Mailing address:
  • Phone: 650-697-4195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WENGUANG ZHAO
Title or Position: PRESIDENT
Credential: M. D.
Phone: 650-697-4195