Healthcare Provider Details

I. General information

NPI: 1487115127
Provider Name (Legal Business Name): CHENGHAO QIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST # 3400
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

2182 EAST ST
CONCORD CA
94520-2012
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-4597
  • Fax:
Mailing address:
  • Phone: 925-685-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA176421
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA176241
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: