Provider Demographics
NPI:1437104031
Name:QUAN, M MING (MD)
Entity type:Individual
Prefix:
First Name:M
Middle Name:MING
Last Name:QUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MARVIN
Other - Middle Name:YUT-MING
Other - Last Name:QUAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3838 CALIFORNIA ST
Mailing Address - Street 2:STE 408
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-221-6668
Mailing Address - Fax:415-221-2942
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:STE 408
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-221-6668
Practice Address - Fax:415-221-2942
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36056207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG360560Medicaid
OOG360560Medicare ID - Type Unspecified
CAOOG360560Medicaid