Healthcare Provider Details

I. General information

NPI: 1124609532
Provider Name (Legal Business Name): LIRONG ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11169 ROSARITA DR
LOMA LINDA CA
92354-3207
US

IV. Provider business mailing address

11169 ROSARITA DR
LOMA LINDA CA
92354-3207
US

V. Phone/Fax

Practice location:
  • Phone: 909-642-3665
  • Fax:
Mailing address:
  • Phone: 909-642-3665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95017791
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: