Healthcare Provider Details
I. General information
NPI: 1023707882
Provider Name (Legal Business Name): KEKE ZHENG & COMPANY ANESTHESIA, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2023
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
541 S PASADENA AVE
GLENDORA CA
91741-6232
US
IV. Provider business mailing address
5 HOLLAND STE 101
IRVINE CA
92618-2568
US
V. Phone/Fax
- Phone: 626-610-1850
- Fax:
- Phone: 949-588-2190
- Fax: 949-588-2199
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEKE
ZHENG
Title or Position: OWNER
Credential: CRNA
Phone: 949-588-2190