Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A105851 | CA |
NPI | 1417180290 |
---|---|
Provider Name | Xueren Zhao |
First Address | Los Angeles, CA 90066-1653 |
Second Address | Los Angeles, CA 90066-1653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2009 |
Last Update Date | 27/08/2009 |