Provider Demographics
NPI:1851385009
Name:ZHAO, MENG (MD)
Entity Type:Individual
Prefix:
First Name:MENG
Middle Name:
Last Name:ZHAO
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 1:35800 BOB HOPE DR STE 255
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1786
Mailing Address - Country:US
Mailing Address - Phone:760-773-3379
Mailing Address - Fax:
Practice Address - Street 1:35800 BOB HOPE DR STE 255
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1786
Practice Address - Country:US
Practice Address - Phone:760-773-3379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011005795207R00000X
CAC53907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206572406Medicaid
NY02596078Medicaid
I20606Medicare UPIN