Provider Demographics
NPI:1497986145
Name:ZHAO, YONG JI (DC)
Entity Type:Individual
Prefix:DR
First Name:YONG JI
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-2507
Mailing Address - Country:US
Mailing Address - Phone:323-467-0088
Mailing Address - Fax:323-467-0688
Practice Address - Street 1:4911 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-2507
Practice Address - Country:US
Practice Address - Phone:323-467-0088
Practice Address - Fax:323-467-0688
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor