Provider Demographics
NPI:1093205510
Name:FENG, ZHIQI (DO)
Entity Type:Individual
Prefix:
First Name:ZHIQI
Middle Name:
Last Name:FENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5668
Mailing Address - Country:US
Mailing Address - Phone:702-805-1880
Mailing Address - Fax:702-330-0250
Practice Address - Street 1:2995 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5668
Practice Address - Country:US
Practice Address - Phone:702-805-1880
Practice Address - Fax:702-330-0250
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSL1334207Q00000X
NVDO2899207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine