Provider Demographics
NPI:1619166626
Name:ZHANG, SHANQIANG
Entity Type:Individual
Prefix:MR
First Name:SHANQIANG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10331 SPARKLING DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0315
Mailing Address - Country:US
Mailing Address - Phone:909-483-2652
Mailing Address - Fax:909-483-2652
Practice Address - Street 1:1680 S GARFIELD AVE STE 204
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5413
Practice Address - Country:US
Practice Address - Phone:818-839-5200
Practice Address - Fax:818-839-5190
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA19369363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical