Provider Demographics
NPI:1972026888
Name:ZHANG, ANDY
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 S ETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-3816
Mailing Address - Country:US
Mailing Address - Phone:626-679-1539
Mailing Address - Fax:
Practice Address - Street 1:1045 E VALLEY BLVD
Practice Address - Street 2:# 202
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3661
Practice Address - Country:US
Practice Address - Phone:626-679-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program