Healthcare Provider Details

I. General information

NPI: 1639424732
Provider Name (Legal Business Name): COLIN ZHU D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 S EL CAMINO REAL STE 117-122
OCEANSIDE CA
92054-6203
US

IV. Provider business mailing address

46 LONTANO
LAKE FOREST CA
92630-7058
US

V. Phone/Fax

Practice location:
  • Phone: 760-730-8060
  • Fax: 760-730-8061
Mailing address:
  • Phone: 908-216-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: