Healthcare Provider Details
I. General information
NPI: 1699578534
Provider Name (Legal Business Name): ERIC ZHUANG MD, MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20311 SW ACACIA ST STE 150
NEWPORT BEACH CA
92660-1733
US
IV. Provider business mailing address
23 CRESTVIEW DR
RANCHO SANTA MARGARITA CA
92688-5548
US
V. Phone/Fax
- Phone: 949-357-0753
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
ZHUANG
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 949-356-8083