Healthcare Provider Details

I. General information

NPI: 1750970620
Provider Name (Legal Business Name): ALEXANDER QIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PARNASSUS AVE
SAN FRANCISCO CA
94143-2203
US

IV. Provider business mailing address

20 JUNEBERRY
IRVINE CA
92606-4503
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7175
  • Fax:
Mailing address:
  • Phone: 949-231-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberA187509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: