Healthcare Provider Details

I. General information

NPI: 1477014645
Provider Name (Legal Business Name): DAVID JIANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE # S321
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

513 PARNASSUS AVE # S321
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1239
  • Fax:
Mailing address:
  • Phone: 415-476-1239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125.074290
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: