Provider Demographics
NPI:1952560500
Name:ZHOU, JIANXUN
Entity type:Individual
Prefix:DR
First Name:JIANXUN
Middle Name:
Last Name:ZHOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4219 MAHOGANY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-6080
Mailing Address - Country:US
Mailing Address - Phone:734-972-5824
Mailing Address - Fax:
Practice Address - Street 1:1104 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3875
Practice Address - Country:US
Practice Address - Phone:734-972-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246447208100000X
IL036.130931208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation