Healthcare Provider Details

I. General information

NPI: 1801545165
Provider Name (Legal Business Name): AMANDA GRACE ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HEALTH SCIENCES RD
IRVINE CA
92617-3058
US

IV. Provider business mailing address

850 HEALTH SCIENCES RD
IRVINE CA
92617-3058
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-0606
  • Fax: 949-824-1641
Mailing address:
  • Phone: 949-824-0606
  • Fax: 949-824-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA210825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: