Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 95011610 | CA |
NPI | 1023657764 |
---|---|
Provider Name | Qingyu Zhong |
First Address | Cupertino, CA 95014-0623 |
Second Address | Cupertino, CA 95014-0623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2019 |
Last Update Date | 28/12/2019 |