Healthcare Provider Details

I. General information

NPI: 1174448245
Provider Name (Legal Business Name): ZHAO XUN FENG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: FRED FENG MD

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD # 88
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-1860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA211244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: