Healthcare Provider Details
I. General information
NPI: 1619980901
Provider Name (Legal Business Name): KUN ZHONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/15/2006
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1091 BARRY PL
ESCONDIDO CA
92026-1655
US
IV. Provider business mailing address
21000 MIDDLEBELT RD
FARMINGTON HILLS MI
48336-5546
US
V. Phone/Fax
- Phone: 248-345-4798
- Fax:
- Phone: 248-474-3132
- Fax: 248-474-3181
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | KZ063288 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | C199437 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: