Provider Demographics
NPI:1568708147
Name:ZENG, WENQI (PHD)
Entity Type:Individual
Prefix:DR
First Name:WENQI
Middle Name:
Last Name:ZENG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:WAYNE
Other - Middle Name:
Other - Last Name:ZENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:15 ARGONAUT
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1423
Mailing Address - Country:US
Mailing Address - Phone:949-900-5712
Mailing Address - Fax:
Practice Address - Street 1:15 ARGONAUT
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-1423
Practice Address - Country:US
Practice Address - Phone:949-900-5712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-30
Last Update Date:2012-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADRN35291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory