Provider Demographics
NPI:1972266138
Name:QIN, XUAN (MS, RDN)
Entity Type:Individual
Prefix:
First Name:XUAN
Middle Name:
Last Name:QIN
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:QIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RDN
Mailing Address - Street 1:7189 BLUE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3622
Mailing Address - Country:US
Mailing Address - Phone:617-922-0113
Mailing Address - Fax:
Practice Address - Street 1:7189 BLUE HILL DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3622
Practice Address - Country:US
Practice Address - Phone:617-922-0113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered