Provider Demographics
NPI:1043618366
Name:ZHAI, JING
Entity Type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:ZHAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 MARTIN LUTHER KING JR AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3616
Mailing Address - Country:US
Mailing Address - Phone:310-266-0244
Mailing Address - Fax:
Practice Address - Street 1:1090 MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3616
Practice Address - Country:US
Practice Address - Phone:310-266-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-18
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235707176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife