Healthcare Provider Details

I. General information

NPI: 1417717570
Provider Name (Legal Business Name): CE ZHANG MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S SAN VICENTE BLVD # A6600
LOS ANGELES CA
90048-3311
US

IV. Provider business mailing address

127 S SAN VICENTE BLVD
LOS ANGELES CA
90048-3311
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-6742
  • Fax: 310-423-0148
Mailing address:
  • Phone: 310-423-6742
  • Fax: 310-423-0148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA206793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: