Provider Demographics
NPI:1649404831
Name:DZAU, JACQUELINE ROBYN (JACQUELINE DZAU)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:ROBYN
Last Name:DZAU
Suffix:
Gender:F
Credentials:JACQUELINE DZAU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 ERWIN RD APT 2415
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4873
Mailing Address - Country:US
Mailing Address - Phone:858-922-1279
Mailing Address - Fax:
Practice Address - Street 1:2616 ERWIN RD APT 2415
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4873
Practice Address - Country:US
Practice Address - Phone:858-922-1279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program