Provider Demographics
NPI:1881769263
Name:ZHANG, MARK ZHIMING (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ZHIMING
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 981145
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95798-1145
Mailing Address - Country:US
Mailing Address - Phone:916-399-8833
Mailing Address - Fax:916-399-1168
Practice Address - Street 1:1740 FRUITRIDGE RD STE 103
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-3067
Practice Address - Country:US
Practice Address - Phone:916-399-8833
Practice Address - Fax:916-399-1168
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA85374207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A853740Medicaid
CAI08180Medicare UPIN
CA00A853740Medicaid