Healthcare Provider Details

I. General information

NPI: 1619557725
Provider Name (Legal Business Name): CONNIE ZHAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 HICKEY BLVD
DALY CITY CA
94015-2770
US

IV. Provider business mailing address

5820 OWENS DR BLDG E2FL
PLEASANTON CA
94588-3900
US

V. Phone/Fax

Practice location:
  • Phone: 650-742-2000
  • Fax:
Mailing address:
  • Phone: 510-625-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA209502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: