Healthcare Provider Details

I. General information

NPI: 1093597411
Provider Name (Legal Business Name): SHENGYUE ZHANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 CITY PKWY W
ORANGE CA
92868-2924
US

IV. Provider business mailing address

12770 BRIARCREST PL APT 88
SAN DIEGO CA
92130-5728
US

V. Phone/Fax

Practice location:
  • Phone: 714-246-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number86935
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: