Basic Information
Provider Information
NPI: 1720156946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHEN
FirstName: ZHONG YONG
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 216 EST
Address2: 76
City: DAVIS
State: CA
PostalCode: 95616
CountryCode: US
TelephoneNumber: 5306688988
FaxNumber: 5306681229
Practice Location
Address1: 2025 MORSE AVE
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 95825
CountryCode: US
TelephoneNumber: 9169736847
FaxNumber: 9169735611
Other Information
ProviderEnumerationDate: 12/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
246ZE0600X  Y Technologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic

No ID Information.


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