MEDICARE: CAROLINE ZHU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1184373292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE ZHU

Provider Business Mailing Address
First Line	:	2757 SCENIC DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-4155
Country	:	US
Telephone Number	:	972-988-9193
Fax Number	:

Provider Business Practice Location Address
First Line	:	4077 FIFTH AVE # MER-35
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-2105
Country	:	US
Telephone Number	:	619-294-8111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	03/23/2022

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Directions to “ CAROLINE ZHU ” Practice Location

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