Provider Demographics
NPI:1033178744
Name:QI, JASON (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:QI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S ATLANTIC BLVD
Mailing Address - Street 2:#231C
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4717
Mailing Address - Country:US
Mailing Address - Phone:626-284-8848
Mailing Address - Fax:
Practice Address - Street 1:790 W AVENUE Q
Practice Address - Street 2:STE A
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3768
Practice Address - Country:US
Practice Address - Phone:661-272-1800
Practice Address - Fax:661-272-9861
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor