Provider Demographics
NPI:1447227657
Name:ZHAO, HAIHONG HELEN (MD)
Entity Type:Individual
Prefix:
First Name:HAIHONG
Middle Name:HELEN
Last Name:ZHAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19636 N 27TH AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4013
Mailing Address - Country:US
Mailing Address - Phone:623-780-1999
Mailing Address - Fax:623-516-0950
Practice Address - Street 1:19636 N 27TH AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4013
Practice Address - Country:US
Practice Address - Phone:623-780-1999
Practice Address - Fax:623-516-0950
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ106046Medicare ID - Type Unspecified
AZH49064Medicare UPIN