Healthcare Provider Details
I. General information
NPI: 1114203395
Provider Name (Legal Business Name): MARTIN YAO HUA ZHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/01/2011
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
706 ALHAMBRA AVE
MARTINEZ CA
94553-1602
US
IV. Provider business mailing address
706 ALHAMBRA AVE
MARTINEZ CA
94553-1602
US
V. Phone/Fax
- Phone: 415-568-1569
- Fax:
- Phone: 415-568-1569
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 9176 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: