Provider Demographics
NPI:1700016813
Name:ZHOU, WEIDONG (MD)
Entity Type:Individual
Prefix:DR
First Name:WEIDONG
Middle Name:
Last Name:ZHOU
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 1:33608 ORTEGA HWY
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92690
Mailing Address - Country:US
Mailing Address - Phone:949-728-4188
Mailing Address - Fax:
Practice Address - Street 1:33608 ORTEGA HWY
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92690
Practice Address - Country:US
Practice Address - Phone:949-728-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 67232207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology