Provider Demographics
NPI:1013598804
Name:ZHAO, DAWEI (MD)
Entity type:Individual
Prefix:
First Name:DAWEI
Middle Name:
Last Name:ZHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 PARK TER STE 500
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-9212
Mailing Address - Country:US
Mailing Address - Phone:310-665-7235
Mailing Address - Fax:310-665-7296
Practice Address - Street 1:6801 PARK TER STE 500
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-9212
Practice Address - Country:US
Practice Address - Phone:310-665-7235
Practice Address - Fax:310-665-7296
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA195770207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program