1164596102 NPI number — MR. TONG ZHANG ACUPUNCTURIST

Table of content: MR. TONG ZHANG ACUPUNCTURIST (NPI 1164596102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164596102 NPI number — MR. TONG ZHANG ACUPUNCTURIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHANG
Provider First Name:
TONG
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
ACUPUNCTURIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164596102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
599 9TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94607-3837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-628-0638
Provider Business Mailing Address Fax Number:
415-788-0899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
728 PACIFIC AVE
Provider Second Line Business Practice Location Address:
SUITE 606
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94133-4457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-788-1788
Provider Business Practice Location Address Fax Number:
415-788-0899
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC8618 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CA0086181 . This is a "BLUE SHIELD OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1037997 . This is a "AMERICAN SPECIALTY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 672664 . This is a "OPTUM HEALTH PHYSICAL HEALTH OF CALIFORNIA, INC." identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 607347700 . This is a "DEPT OF LABOR - OWCP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: AC0086180 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: ACA618B . This is a "LANDMARK HEALTHCARE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: CA0086180 . This is a "BLUE SHIELD OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 710978274 . This is a "BLUE CROSS OF CALIFORNIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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