Healthcare Provider Details

I. General information

NPI: 1275920977
Provider Name (Legal Business Name): MICHAEL LIN ZHANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL ZHANG M.D.

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 N CALIFORNIA ST STE 201
STOCKTON CA
95204-6032
US

IV. Provider business mailing address

1805 N CALIFORNIA ST STE 201
STOCKTON CA
95204-6032
US

V. Phone/Fax

Practice location:
  • Phone: 209-645-4005
  • Fax: 209-645-6344
Mailing address:
  • Phone: 209-645-4005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA168082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: