Healthcare Provider Details
I. General information
NPI: 1497953558
Provider Name (Legal Business Name): YING ZHANG MD PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2007
Last Update Date: 08/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 MOORPARK AVE SUITE 119
SAN JOSE CA
95128-2631
US
IV. Provider business mailing address
PO BOX 352
PALO ALTO CA
94302-0352
US
V. Phone/Fax
- Phone: 408-288-6188
- Fax: 408-288-6187
- Phone: 408-288-6188
- Fax: 408-288-6187
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | A88806 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A88806 |
| License Number State | CA |
VIII. Authorized Official
Name:
YING
ZHANG
Title or Position: OWNER
Credential: M.D.
Phone: 408-288-6188