Healthcare Provider Details

I. General information

NPI: 1942838792
Provider Name (Legal Business Name): HARRY ZIYU ZHAO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15944 LOS SERRANOS COUNTRY CLUB DR STE 160
CHINO HILLS CA
91709-3990
US

IV. Provider business mailing address

15944 LOS SERRANOS COUNTRY CLUB DR STE 160
CHINO HILLS CA
91709-3990
US

V. Phone/Fax

Practice location:
  • Phone: 909-606-8893
  • Fax: 909-606-8828
Mailing address:
  • Phone: 714-504-6772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A21209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: