Provider Demographics
NPI:1972572188
Name:QIAN, DAVY Z (DO)
Entity Type:Individual
Prefix:
First Name:DAVY
Middle Name:Z
Last Name:QIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660069
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-0069
Mailing Address - Country:US
Mailing Address - Phone:626-482-7297
Mailing Address - Fax:626-226-4028
Practice Address - Street 1:501 S 1ST AVE
Practice Address - Street 2:#F
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3888
Practice Address - Country:US
Practice Address - Phone:626-482-7297
Practice Address - Fax:626-226-4028
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A79872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A431890Medicaid
CAW12116Medicare ID - Type Unspecified
CA00A431890Medicaid