1306138961 NPI number — MR. YUBO ZHANG AC 13984

Table of content: MR. YUBO ZHANG AC 13984 (NPI 1306138961)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306138961 NPI number — MR. YUBO ZHANG AC 13984

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZHANG
Provider First Name:
YUBO
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
AC 13984
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:
1306138961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 BAYWOOD AVE
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
SAN MATEO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94402-1537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-579-2818
Provider Business Mailing Address Fax Number:
650-579-2818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 BAYWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
SAN MATEO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94402-1537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-579-2818
Provider Business Practice Location Address Fax Number:
650-579-2818
Provider Enumeration Date:
05/13/2011

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:  13984 , 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)





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