Provider Demographics
NPI:1184657553
Name:ZHAN, LINA (LAC OMD)
Entity Type:Individual
Prefix:DR
First Name:LINA
Middle Name:
Last Name:ZHAN
Suffix:
Gender:F
Credentials:LAC OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 CAMPUS DR
Mailing Address - Street 2:100
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1814
Mailing Address - Country:US
Mailing Address - Phone:949-250-0098
Mailing Address - Fax:949-250-7398
Practice Address - Street 1:4500 CAMPUS DR
Practice Address - Street 2:100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1814
Practice Address - Country:US
Practice Address - Phone:949-250-0098
Practice Address - Fax:949-250-7398
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist