Provider Demographics
NPI:1205231974
Name:ZHU, TONY (LAC)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:ZHU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1288 KIFER RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-5326
Mailing Address - Country:US
Mailing Address - Phone:408-306-9393
Mailing Address - Fax:
Practice Address - Street 1:1288 KIFER RD STE 202
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5326
Practice Address - Country:US
Practice Address - Phone:408-306-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16291171100000X
CA57500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist