Provider Demographics
NPI:1285826669
Name:PACIFIC HORIZON MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:PACIFIC HORIZON MEDICAL CENTER INC.
Other - Org Name:PACIFIC ROYAL MEDICAL CENTER INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ZHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:626-300-8880
Mailing Address - Street 1:316 E LAS TUNAS DR STE 102
Mailing Address - Street 2:316 E LAS TUNAS DR 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:626-300-8811
Practice Address - Street 1:316 E LAS TUNAS DR STE 102
Practice Address - Street 2:316 E. LAS TUNAS DRIVE, SUITE 102
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1535
Practice Address - Country:US
Practice Address - Phone:626-300-8880
Practice Address - Fax:626-300-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70119261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A701190Medicaid
W15904Medicare PIN
CA00A701190Medicaid