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General NPI Number Information
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NPI Number | 1619112455
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Entity Type | Individual
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Provider Name | QIN FANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2008
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 1051 WELLNESS PL STE 140
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City | HENDERSON
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State | NV
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Zip | 89011-2338
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Country | US
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Telephone | 702-289-4037
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Fax | 725-205-3833
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Provider Business Mailing Address
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Address Line | 2545 S BRUCE ST STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89169-1778
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Country | US
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Telephone | 702-732-2438
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Fax | 702-737-5043
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 14962
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License Number State | NV
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