Healthcare Provider Details

I. General information

NPI: 1659769073
Provider Name (Legal Business Name): ZEMENG LUO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 JACKSON ST FL B1
SAN FRANCISCO CA
94133-4899
US

IV. Provider business mailing address

845 JACKSON ST # B1
SAN FRANCISCO CA
94133-4851
US

V. Phone/Fax

Practice location:
  • Phone: 415-677-2370
  • Fax: 415-217-4181
Mailing address:
  • Phone: 415-677-2370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number806560
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022858
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: