=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639424732
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | COLIN ZHU D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2012
-----------------------------------------------------
Last Update Date | 06/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2170 S EL CAMINO REAL STE 117-122
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92054-6203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-730-8060
-----------------------------------------------------
Fax | 760-730-8061
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 46 LONTANO
-----------------------------------------------------
City | LAKE FOREST
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92630-7058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-216-6326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 14710
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------