Provider Demographics
NPI:1780753764
Name:ZHENG, ZHI LI (LAC)
Entity type:Individual
Prefix:
First Name:ZHI LI
Middle Name:
Last Name:ZHENG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3300
Mailing Address - Country:US
Mailing Address - Phone:626-642-0363
Mailing Address - Fax:626-642-0361
Practice Address - Street 1:600 W MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3300
Practice Address - Country:US
Practice Address - Phone:626-642-0363
Practice Address - Fax:626-642-0361
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5988171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0059881Medicaid
CAAC5988OtherLICENSE NUMBER