MEDICARE: MR. QING ZHU ZHANG

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	AC8339	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AC8339	OTHER	CA	ACUPUNCTURIST

General Provider Information

NPI Number	:	1629163027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. QING ZHU ZHANG

Provider Business Mailing Address
First Line	:	107 E BEACON ST #C
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801
Country	:	US
Telephone Number	:	626-475-2188
Fax Number	:	213-587-0911

Provider Business Practice Location Address
First Line	:	20627 GOLDEN SPRINGS DR
Second Line	:	SUITE J
City	:	DIAMOND BAR
State	:	CA
Zip	:	91789-4814
Country	:	US
Telephone Number	:	626-475-2188
Fax Number	:	213-587-0911

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	10/30/2014

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