Provider Demographics
NPI:1093801854
Name:ZENG, ZHI (MD)
Entity Type:Individual
Prefix:DR
First Name:ZHI
Middle Name:
Last Name:ZENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E LAS TUNAS DR
Mailing Address - Street 2:STE 102
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1535
Mailing Address - Country:US
Mailing Address - Phone:626-300-8880
Mailing Address - Fax:
Practice Address - Street 1:316 E LAS TUNAS DR STE 102
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1504
Practice Address - Country:US
Practice Address - Phone:626-300-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70119207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093801854OtherNPI
CA00A701190Medicaid
H07257Medicare UPIN
W15904Medicare PIN
CA00A701190Medicaid