Provider Demographics
NPI:1023555331
Name:ZHANG, YAN (DOM)
Entity Type:Individual
Prefix:
First Name:YAN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CUTLER AVE NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4098
Mailing Address - Country:US
Mailing Address - Phone:505-888-6700
Mailing Address - Fax:505-888-6701
Practice Address - Street 1:5000 CUTLER AVE NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4098
Practice Address - Country:US
Practice Address - Phone:505-888-6700
Practice Address - Fax:505-888-6701
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist