Provider Demographics
NPI:1811766546
Name:ZHANG, HAN
Entity type:Individual
Prefix:
First Name:HAN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15677 DIMITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2933
Mailing Address - Country:US
Mailing Address - Phone:626-589-4586
Mailing Address - Fax:
Practice Address - Street 1:3006 N. SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2933
Practice Address - Country:US
Practice Address - Phone:626-773-8900
Practice Address - Fax:626-940-5225
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily