Individual provider Active NPI

Jian-Hua Qiao, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1073539854
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A72566 Issued in CA
Practice address
1401 S Grand Ave
Pathology Dept
Los Angeles, CA 90015-3010
Phone
(213) 742-5791
Fax
(213) 742-6373
NPI assigned
Jul 14, 2006
Last updated
Jun 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A72566 CA Primary

Addresses

Primary practice location

1401 S Grand Ave
Pathology Dept
Los Angeles, CA 90015-3010

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Other identifiers 1

IdentifierTypeStateIssuer
00A725660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040828000160 CA Practitioner - Pathology 0749255255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cmcla Pathology Medical GroupGroup PAC ID 7113988700, 2 clinicians

Practice addresses (Care Compare)

1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 748-2411

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A72566CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cmcla Pathology Medical Group Anatomic Pathology & Clinical Pathology CurrentSince Apr 29, 2009 Accepting new patients

Locations

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1073539854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GRAND AVE",
            "address_2": "PATHOLOGY DEPT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153010",
            "telephone_number": "213-742-5791",
            "fax_number": "213-742-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIAO",
        "first_name": "JIAN-HUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A72566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A725660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.