Provider Demographics
NPI:1891829271
Name:LI, YI QUN (MD)
Entity Type:Individual
Prefix:
First Name:YI QUN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6316 ARGONNE BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3902
Mailing Address - Country:US
Mailing Address - Phone:504-667-6993
Mailing Address - Fax:504-270-1004
Practice Address - Street 1:6316 ARGONNE BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3902
Practice Address - Country:US
Practice Address - Phone:504-667-6993
Practice Address - Fax:504-270-1004
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA203672208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1056677Medicaid