Provider Demographics
NPI:1235271933
Name:ZHAO, NA (LAC)
Entity type:Individual
Prefix:
First Name:NA
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BROWN RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7955
Mailing Address - Country:US
Mailing Address - Phone:510-656-6390
Mailing Address - Fax:
Practice Address - Street 1:200 BROWN RD
Practice Address - Street 2:SUITE 206
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7955
Practice Address - Country:US
Practice Address - Phone:510-656-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7275171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist