Healthcare Provider Details

I. General information

NPI: 1659710127
Provider Name (Legal Business Name): JANET ZHU D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26520 CACTUS AVE
MORENO VALLEY CA
92555-3927
US

IV. Provider business mailing address

PO BOX 1628
ORANGE CA
92856-0628
US

V. Phone/Fax

Practice location:
  • Phone: 951-486-4574
  • Fax: 951-486-4560
Mailing address:
  • Phone: 714-619-5391
  • Fax: 770-701-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A14024
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: