Healthcare Provider Details

I. General information

NPI: 1760464648
Provider Name (Legal Business Name): ZHI JIAR ZHUANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3122 GEARY BLVD #101
SAN FRANCISCO CA
94118-3317
US

IV. Provider business mailing address

1600 WEBSTER ST #307
SAN FRANCISCO CA
94115-3222
US

V. Phone/Fax

Practice location:
  • Phone: 415-948-9546
  • Fax: 415-352-2050
Mailing address:
  • Phone: 415-948-9546
  • Fax: 415-352-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA069568-PHYSICIAN
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: