Provider Demographics
NPI:1790073252
Name:LI, ZHENBO (PA)
Entity Type:Individual
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First Name:ZHENBO
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:125 WHIPPLE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3258
Mailing Address - Country:US
Mailing Address - Phone:401-519-0330
Mailing Address - Fax:401-427-7795
Practice Address - Street 1:250 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2926
Practice Address - Country:US
Practice Address - Phone:641-494-5200
Practice Address - Fax:641-494-5403
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2024-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA002219363A00000X
RIPA01533363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant