Provider Demographics
NPI:1992521603
Name:ZHOU, JIANWEI (PA-C)
Entity type:Individual
Prefix:
First Name:JIANWEI
Middle Name:
Last Name:ZHOU
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SHOREWAY RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-2718
Mailing Address - Country:US
Mailing Address - Phone:323-348-6425
Mailing Address - Fax:
Practice Address - Street 1:125 SHOREWAY RD STE A
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2718
Practice Address - Country:US
Practice Address - Phone:323-348-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65475363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant