Basic Information
| Provider Information | |||||||||
| NPI: | 1437286036 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZHOU | ||||||||
| FirstName: | FAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1303 E HERNDON AVE | ||||||||
| Address2: | SAINT AGNES MEDICAL CENTER | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594503817 | ||||||||
| FaxNumber: | 5594502035 | ||||||||
| Practice Location | |||||||||
| Address1: | 1303 E HERNDON AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937203309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595403817 | ||||||||
| FaxNumber: | 5594502035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 06/06/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZH0000X | MD00048355 | WA | N | Allopathic & Osteopathic Physicians | Pathology | Hematology | 207ZH0000X | M-8886 | ID | N | Allopathic & Osteopathic Physicians | Pathology | Hematology | 207ZP0102X | C143678 | CA | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | M-8886 | ID | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD00048355 | WA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | H29105 | 05 | CA | MEDICAID |