Provider Demographics
NPI:1669893384
Name:ZHANG, RUI-TAO (MD)
Entity type:Individual
Prefix:DR
First Name:RUI-TAO
Middle Name:
Last Name:ZHANG
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:LOMA LINDA UNIVERSITY
Mailing Address - Street 2:11234 ANDERSON ST, MC-1590
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2741
Mailing Address - Country:US
Mailing Address - Phone:909-558-4884
Mailing Address - Fax:909-558-0428
Practice Address - Street 1:LOMA LINDA UNIVERSITY
Practice Address - Street 2:11234 ANDERSON ST, MC-1590
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2741
Practice Address - Country:US
Practice Address - Phone:909-558-4884
Practice Address - Fax:909-558-0428
Is Sole Proprietor?:No
Enumeration Date:2013-12-23
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128943207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine