Individual provider Active NPI

Yin Xia Qian, P.A.

  • Physician Assistant
  • Victorville, CA
National Provider Identifier
1548218811
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16174 Issued in CA
Practice address
15248 11TH St
Emergency Department
Victorville, CA 92395-3704
Phone
(760) 245-8691
Fax
(760) 843-6020
NPI assigned
May 5, 2006
Last updated
Dec 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16174 CA Primary

Addresses

Primary practice location

15248 11TH St
Emergency Department
Victorville, CA 92395-3704

Mailing address

4551 Glencoe Ave
Suite 260
Marina del Rey, CA 90292-6385
Phone (310) 301-2030

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
I20050108000181 CA Practitioner - Physician Assistant 9032167853 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Star Hospital Associates Inc. CurrentSince Sep 1, 2021 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Apr 18, 2010 Accepting new patients
Desert Valley Medical Group, Inc CurrentSince Apr 18, 2010 Accepting new patients
Victor Valley Emergency Medical Associates, Inc. Past Accepting new patients

Locations

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

16850 Bear Valley Rd
Victorville, CA 92395

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1548218811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4551 GLENCOE AVE",
            "address_2": "SUITE 260",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926385",
            "telephone_number": "310-301-2030",
            "fax_number": "310-306-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15248 11TH ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953704",
            "telephone_number": "760-245-8691",
            "fax_number": "760-843-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIAN",
        "first_name": "YIN",
        "middle_name": "XIA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.