Provider Demographics
NPI:1467938340
Name:QUANG MEDICAL PRACTICE, INC.
Entity Type:Organization
Organization Name:QUANG MEDICAL PRACTICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-885-8080
Mailing Address - Street 1:1199 BUSH ST STE 560
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5976
Mailing Address - Country:US
Mailing Address - Phone:415-885-8080
Mailing Address - Fax:415-885-8081
Practice Address - Street 1:1199 BUSH ST STE 560
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5976
Practice Address - Country:US
Practice Address - Phone:415-885-8080
Practice Address - Fax:415-885-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center