Provider Demographics
NPI:1558442020
Name:ZHU, LI (MD)
Entity Type:Individual
Prefix:DR
First Name:LI
Middle Name:
Last Name:ZHU
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 1:101 CALLAN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4584
Mailing Address - Country:US
Mailing Address - Phone:510-357-7077
Mailing Address - Fax:510-357-4364
Practice Address - Street 1:101 CALLAN AVE STE 105
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4584
Practice Address - Country:US
Practice Address - Phone:510-357-7077
Practice Address - Fax:510-357-4364
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85043208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A850430Medicaid