Provider Demographics
NPI:1841447182
Name:GUAN, ZHEN (MB)
Entity type:Individual
Prefix:MR
First Name:ZHEN
Middle Name:
Last Name:GUAN
Suffix:
Gender:M
Credentials:MB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3827 ORANGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1866
Mailing Address - Country:US
Mailing Address - Phone:818-541-9768
Mailing Address - Fax:818-541-9768
Practice Address - Street 1:3827 ORANGEDALE AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1866
Practice Address - Country:US
Practice Address - Phone:818-541-9768
Practice Address - Fax:818-541-9768
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12509171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist