Provider Demographics
NPI:1649290891
Name:QIAN, JOHN XIAO-JIANG (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:XIAO-JIANG
Last Name:QIAN
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 1:5395 RUFFIN ROAD.
Mailing Address - Street 2:STE. 204
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1338
Mailing Address - Country:US
Mailing Address - Phone:858-571-3630
Mailing Address - Fax:858-571-3649
Practice Address - Street 1:5395 RUFFIN ROAD.
Practice Address - Street 2:STE. 204
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1338
Practice Address - Country:US
Practice Address - Phone:858-571-3630
Practice Address - Fax:858-571-3640
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA724302081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A724300Medicaid
H82215Medicare UPIN
A0899AMedicare PIN
A72430Medicare PIN