Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | A63200 | CA |
NPI | 1023074341 |
---|---|
Provider Name | Dr. Douglas D Zhang |
First Address | San Leandro, CA 94578-2628 |
Second Address | San Leandro, CA 94578-2628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 23/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G86907 | (02) | CA |