Provider Demographics
NPI:1821752635
Name:DAI, QIANGHUI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:QIANGHUI
Middle Name:
Last Name:DAI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:SHOSHANA
Other - Middle Name:
Other - Last Name:DAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURES PRACTITIONER
Mailing Address - Street 1:325 S DOHENY DR APT 6
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3525
Mailing Address - Country:US
Mailing Address - Phone:310-840-7089
Mailing Address - Fax:
Practice Address - Street 1:3831 HUGHES AVE STE 105
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6834
Practice Address - Country:US
Practice Address - Phone:310-840-7089
Practice Address - Fax:310-558-1302
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018588363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care