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NPI 1508966078

NPI 1508966078 : ZHIBIN QIU, D.D.S., A PROFESSIONAL CORP. : MONTEREY PARK, CA

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General NPI Number Information
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    NPI Number           |    1508966078
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    Entity Type          |    Organization 
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    Legal Business Name  |    ZHIBIN QIU, D.D.S., A PROFESSIONAL CORP. 
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Dates
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    Enumeration Date     |    09/25/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    111 N. ATLANTIC BLVD. SUITE 246
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    City                 |    MONTEREY PARK
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    State                |    CA
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    Zip                  |    91754-1579
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    Country              |    US
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    Telephone            |    626-576-1128
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    Fax                  |    626-576-1988
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Provider Business Mailing Address
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    Address Line         |    111 N. ATLANTIC BLVD. SUITE 246
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    City                 |    MONTEREY PARK
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    State                |    CA
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    Zip                  |    91754-1579
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    Country              |    US
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    Telephone            |    626-576-1128
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    Fax                  |    626-576-1988
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. ZHIBIN  QIU 
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    Credential           |    D.D.S.
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    Telephone            |    626-576-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    44991
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    License Number State |    CA
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