Healthcare Provider Details

I. General information

NPI: 1639830896
Provider Name (Legal Business Name): ZHENG CAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2022
Last Update Date: 01/09/2022
Certification Date: 01/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17751 COLIMA RD
CITY OF INDUSTRY CA
91738
US

IV. Provider business mailing address

17751 COLIMA RD
CITY OF INDUSTRY CA
91738
US

V. Phone/Fax

Practice location:
  • Phone: 626-709-0000
  • Fax:
Mailing address:
  • Phone: 626-709-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number85760
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: