Provider Demographics
NPI:1629697438
Name:GENG, XIANZHANG (MD)
Entity Type:Individual
Prefix:
First Name:XIANZHANG
Middle Name:
Last Name:GENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:GENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:801 S CHEVY CHASE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 S CHEVY CHASE DR STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4435
Practice Address - Country:US
Practice Address - Phone:818-500-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-11
Last Update Date:2020-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program