Healthcare Provider Details

I. General information

NPI: 1124447180
Provider Name (Legal Business Name): YUE ZONG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 W SUNSET BLVD FL 3
LOS ANGELES CA
90027-6021
US

IV. Provider business mailing address

4021 N CERRO DE FALCON
TUCSON AZ
85718-6724
US

V. Phone/Fax

Practice location:
  • Phone: 323-783-4516
  • Fax:
Mailing address:
  • Phone: 520-245-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number69841
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: