Healthcare Provider Details

I. General information

NPI: 1427318054
Provider Name (Legal Business Name): TRISTAN ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E CARRILLO ST
SANTA BARBARA CA
93101-1460
US

IV. Provider business mailing address

401 E CARRILLO ST
SANTA BARBARA CA
93101-1460
US

V. Phone/Fax

Practice location:
  • Phone: 469-471-1404
  • Fax:
Mailing address:
  • Phone: 469-471-1404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA161668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: