Provider Demographics
NPI:1043239569
Name:ZHAO, WANGPING (MD)
Entity Type:Individual
Prefix:
First Name:WANGPING
Middle Name:
Last Name:ZHAO
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 1:2400 MOORPARK AVE
Mailing Address - Street 2:SUITE #319
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2631
Mailing Address - Country:US
Mailing Address - Phone:408-975-2763
Mailing Address - Fax:408-975-2764
Practice Address - Street 1:2400 MOORPARK AVE
Practice Address - Street 2:SUITE #319
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2631
Practice Address - Country:US
Practice Address - Phone:408-975-2763
Practice Address - Fax:408-975-2764
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A900160OtherBLUE SHIELD
CAWA90016AMedicare ID - Type Unspecified
CA00A900160OtherBLUE SHIELD