Healthcare Provider Details

I. General information

NPI: 1700064821
Provider Name (Legal Business Name): JU ZHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

IV. Provider business mailing address

921 E COMPTON BLVD
COMPTON CA
90221-3303
US

V. Phone/Fax

Practice location:
  • Phone: 310-668-6840
  • Fax: 310-223-0694
Mailing address:
  • Phone: 310-668-6840
  • Fax: 310-223-0694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA102373
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number250717
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: