Provider Demographics
NPI:1851055412
Name:QI, ZIMIAN
Entity Type:Individual
Prefix:
First Name:ZIMIAN
Middle Name:
Last Name:QI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17830 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1142
Mailing Address - Country:US
Mailing Address - Phone:310-920-5120
Mailing Address - Fax:
Practice Address - Street 1:17830 COLLINS ST
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1142
Practice Address - Country:US
Practice Address - Phone:310-920-5120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant