MEDICARE: BEINAN ZHAO

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	122300000X	Dentist	104136	CA

General Provider Information

NPI Number	:	1619521085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEINAN ZHAO

Provider Business Mailing Address
First Line	:	615 8TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-3701
Country	:	US
Telephone Number	:	415-613-5062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1289 E HILLSDALE BLVD STE 9
Second Line	:
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1219
Country	:	US
Telephone Number	:	650-638-9688
Fax Number	:	650-638-9689

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

Provider Enumeration Date	:	07/24/2019
Last Update Date	:	07/24/2019

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Directions to “ BEINAN ZHAO ” Practice Location

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