Healthcare Provider Details

I. General information

NPI: 1487795241
Provider Name (Legal Business Name): YU JB ZHANG PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 NELSON AVE
MODESTO CA
95350-5341
US

IV. Provider business mailing address

227 SIERRA DR
WALNUT CREEK CA
94596-4817
US

V. Phone/Fax

Practice location:
  • Phone: 209-575-5870
  • Fax: 209-575-5872
Mailing address:
  • Phone: 209-575-5870
  • Fax: 209-575-5872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: