Provider Demographics
NPI:1962467936
Name:ZHANG, QUANWEI (MD)
Entity Type:Individual
Prefix:
First Name:QUANWEI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8460 SVL BOX
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5169
Mailing Address - Country:US
Mailing Address - Phone:760-493-1889
Mailing Address - Fax:888-412-8699
Practice Address - Street 1:16850 BEAR VALLEY RD STE 103
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5794
Practice Address - Country:US
Practice Address - Phone:760-493-1889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC286992084N0400X
NC2006003542084N0400X
CAC546552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA8722Medicaid
CAFP395ZOtherMEDICARE PTAN
NC7902900Medicaid
SC2435Medicare PIN
NC1125Medicare PIN
CAFP395ZOtherMEDICARE PTAN
SCI01536Medicare UPIN