Doctor Name: | DR. JASON MING ZHAO |
NPI Number: | 1811300932 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD, PHD. |
License Number: | 2011562 |
Business Practice Address: | 101 Bodin Cir Family Health Clinic Travis Afb, CA - 945351809 |
Business Phone Number: | 7074233000 |
Business Fax Number: | |
Mailing Address: | 101 Bodin Cir, Family Health Clinic TRAVIS AFB |
State: | CA |
Postal Code: | 945351809 |
Phone Number: | 7074233000 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2014 |
NPI Last Update Date: | 08/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2011562 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |