Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DDS104001 | CA |
NPI | 1003466137 |
---|---|
Provider Name | Xuyu Zhang |
First Address | San Francisco, CA 94122-1351 |
Second Address | San Francisco, CA 94108-2504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2019 |
Last Update Date | 20/09/2019 |