Healthcare Provider Details

I. General information

NPI: 1104961499
Provider Name (Legal Business Name): PORTIA PING ZHENG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 MILLER AVE APT 1
MOUNTAIN VIEW CA
94040-1124
US

IV. Provider business mailing address

1601 CLAY ST
OAKLAND CA
94612-1531
US

V. Phone/Fax

Practice location:
  • Phone: 650-669-1877
  • Fax:
Mailing address:
  • Phone: 650-669-1877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 4689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: