Basic Information
Provider Information
NPI: 1619933850
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHOU
FirstName: MING
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 600 COFFEE RD
Address2:  
City: MODESTO
State: CA
PostalCode: 953554201
CountryCode: US
TelephoneNumber: 2095216097
FaxNumber:  
Practice Location
Address1: 600 COFFEE RD
Address2:  
City: MODESTO
State: CA
PostalCode: 953554201
CountryCode: US
TelephoneNumber: 2095241211
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/25/2006
LastUpdateDate: 06/04/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202XA82941CAY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
207R00000XA82941CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0000XA82941CAN Allopathic & Osteopathic PhysiciansInternal MedicineHematology

ID Information
IDTypeStateIssuerDescription
00A82941005CA MEDICAID


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