MEDICARE: MS. YING QUAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA1700	NV

General Provider Information

NPI Number	:	1760840797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YING QUAN PA-C

Provider Business Mailing Address
First Line	:	2995 S JONES BLVD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5612
Country	:	US
Telephone Number	:	702-805-1880
Fax Number	:	702-330-0250

Provider Business Practice Location Address
First Line	:	2995 S JONES BLVD STE A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5612
Country	:	US
Telephone Number	:	702-805-1880
Fax Number	:	702-330-0250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2016
Last Update Date	:	06/13/2020

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Directions to “ MS. YING QUAN PA-C” Practice Location

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