Individual provider Active NPI

Li Q Qiao, PA

  • Medical Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1306959168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA16087 Issued in CA
Practice address
2825 W 8TH St
102
Los Angeles, CA 90005-1291
Phone
(213) 380-8998
Fax
(213) 380-8998
NPI assigned
Aug 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA16087 CA Primary

Addresses

Primary practice location

2825 W 8TH St
102
Los Angeles, CA 90005-1291

Mailing address

12840 Riverside Dr
#300
North Hollywood, CA 91607-3327
Phone (818) 655-9900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001575 CA Practitioner - Physician Assistant 4385534825 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Van Nuys Family Medical Clinic IncGroup PAC ID 4880180637, 3 clinicians
Vineland Family Medical Center IncGroup PAC ID 5496248601, 3 clinicians
Family Quality Medical Center IncGroup PAC ID 2264918895, 5 clinicians

Practice addresses (Care Compare)

15251 Roscoe Blvd
Panorama City, CA 91402-4401
Phone (818) 602-4477

4418 Vineland Ave
Suite 218
North Hollywood, CA 91602-2159
Phone (747) 724-1825

519 S Victory Blvd
Burbank, CA 91502-2355
Phone (818) 861-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vineland Family Medical Center Inc CurrentSince Nov 8, 2025 Accepting new patients
Van Nuys Family Medical Clinic Inc CurrentSince Nov 8, 2025 Accepting new patients
Sepulveda Family Medical Clinic Inc CurrentSince Nov 8, 2025 Accepting new patients
Family Quality Medical Center Inc CurrentSince Nov 21, 2025 Accepting new patients
Aldad Chiropractic, Inc. Past Accepting new patients

Locations

519 S Victory Blvd
Burbank, CA 91502
Phone (818) 861-7333

15251 Roscoe Blvd
Panorama City, CA 91402
Phone (818) 602-4477

4418 Vineland Ave
Ste 218
Toluca Lake, CA 91602
Phone (818) 275-2243

15243 Vanowen St
Ste 403
Van Nuys, CA 91405
Phone (818) 809-2036

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306959168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12840 RIVERSIDE DR",
            "address_2": "#300",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916073327",
            "telephone_number": "818-655-9900",
            "fax_number": "818-655-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 W 8TH ST",
            "address_2": "102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051291",
            "telephone_number": "213-380-8998",
            "fax_number": "213-380-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIAO",
        "first_name": "LI",
        "middle_name": "Q",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.