Provider Demographics
NPI:1255836235
Name:ZENG, XIANGJIA (CPT)
Entity Type:Individual
Prefix:
First Name:XIANGJIA
Middle Name:
Last Name:ZENG
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:CHANG
Other - Middle Name:
Other - Last Name:ZENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4980 BARRANCA PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-8654
Mailing Address - Country:US
Mailing Address - Phone:630-428-3682
Mailing Address - Fax:
Practice Address - Street 1:4980 BARRANCA PKWY STE 110
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8654
Practice Address - Country:US
Practice Address - Phone:630-428-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT01003946246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPT01003946OtherCALIFORNIA STATE DEPARTMENT OF PUBLIC HEALTH