Provider Demographics
NPI:1033127402
Name:TZENG, MARIAN CHONG-MEI (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:CHONG-MEI
Last Name:TZENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S EL MOLINO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-1703
Mailing Address - Country:US
Mailing Address - Phone:626-799-6931
Mailing Address - Fax:
Practice Address - Street 1:1900 S ATLANTIC BLVD STE 3
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-6340
Practice Address - Country:US
Practice Address - Phone:323-721-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35999208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A359991Medicaid