Healthcare Provider Details

I. General information

NPI: 1578021051
Provider Name (Legal Business Name): TONGQING ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date: 03/22/2021
Reactivation Date: 04/12/2021

III. Provider practice location address

9353 VALLEY BLVD
ROSEMEAD CA
91770-1923
US

IV. Provider business mailing address

9353 VALLEY BLVD
ROSEMEAD CA
91770-1923
US

V. Phone/Fax

Practice location:
  • Phone: 626-287-2988
  • Fax:
Mailing address:
  • Phone: 626-287-2988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW105751
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: