Healthcare Provider Details

I. General information

NPI: 1982342028
Provider Name (Legal Business Name): ALEX TANG ZHAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST
LOS ANGELES CA
90089-1001
US

IV. Provider business mailing address

696 S NEW HAMPSHIRE AVE APT 3119
LOS ANGELES CA
90005-4445
US

V. Phone/Fax

Practice location:
  • Phone: 919-889-7278
  • Fax:
Mailing address:
  • Phone: 919-889-7278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA189882
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: