MEDICARE: MR. EUGENE YIJUN ZHANG PH.D, L.AC.

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	171100000X	Acupuncturist	0121 000105	VA
2	171100000X	Acupuncturist	U00478	MD

General Provider Information

NPI Number	:	1265561690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EUGENE YIJUN ZHANG PH.D, L.AC.

Provider Business Mailing Address
First Line	:	10329 DEMOCRACY LN STE B
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-2559
Country	:	US
Telephone Number	:	703-218-4178
Fax Number	:	703-218-4179

Provider Business Practice Location Address
First Line	:	10329 DEMOCRACY LN STE B
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-2559
Country	:	US
Telephone Number	:	703-218-4178
Fax Number	:	703-218-4179

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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