| Qingquan Medical Inc | |
|
818 Jackson St Ste 202 San Francisco CA 94133-4849 | |
| (415) 312-9094 | |
| (415) 795-9691 |
| Full Name | Qingquan Medical Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 818 Jackson St Ste 202, San Francisco, California |
| Authorized Official Name and Position | Qingquan Fu (OWNER) |
| Authorized Official Contact | 4153129094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Qingquan Medical Inc 710 32nd Ave San Francisco CA 94121-3502 Ph: () - | Qingquan Medical Inc 818 Jackson St Ste 202 San Francisco CA 94133-4849 Ph: (415) 312-9094 |
| NPI Number | 1588074728 |
|---|---|
| Provider Enumeration Date | 04/28/2014 |
| Last Update Date | 02/13/2020 |
| Medicare PECOS PAC ID | 1951526250 |
|---|---|
| Medicare Enrollment ID | O20140630000989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588074728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | C53780 (California) | Primary |
| Provider Name | Qingquan Fu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578673620 PECOS PAC ID: 8729079470 Enrollment ID: I20100115000405 |
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