=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346520558
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUALITY CARE IPA, EVA I LIANG, M.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2011
-----------------------------------------------------
Last Update Date | 08/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10300 W CHARLESTON BLVD SUITE 13-257
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89135-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-709-5449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10300 W CHARLESTON BLVD SUITE 13-257
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89135-1037
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-709-5449
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | EVA I LIANG
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 702-877-2600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 302R00000X
-----------------------------------------------------
Taxonomy Name | Health Maintenance Organization
-----------------------------------------------------
License Number | 9046
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------