Provider Demographics
NPI:1316119324
Name:DAWEI ZHENG, M.D. A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:DAWEI ZHENG, M.D. A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWEI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-457-9879
Mailing Address - Street 1:PO BOX 60157
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95860-0157
Mailing Address - Country:US
Mailing Address - Phone:916-457-9879
Mailing Address - Fax:916-457-4945
Practice Address - Street 1:8701 CENTER PKWY STE 170
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-7920
Practice Address - Country:US
Practice Address - Phone:916-896-1682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6945338Medicaid