Healthcare Provider Details

I. General information

NPI: 1861864571
Provider Name (Legal Business Name): TING ZHANG OD, FAAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 LOGAN ST
DENVER CO
80216-1323
US

IV. Provider business mailing address

4985 MOORHEAD AVE UNIT 3718
BOULDER CO
80305-5522
US

V. Phone/Fax

Practice location:
  • Phone: 720-773-1665
  • Fax:
Mailing address:
  • Phone: 720-722-3377
  • Fax: 720-596-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0003176
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPT.0003176
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: