Provider Demographics
NPI:1982282760
Name:ZHANG, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ZHANG
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 1:1495 BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2004
Mailing Address - Country:US
Mailing Address - Phone:626-376-7160
Mailing Address - Fax:
Practice Address - Street 1:1111 GRAND AVE STE A
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-2230
Practice Address - Country:US
Practice Address - Phone:909-860-6768
Practice Address - Fax:909-860-4224
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist