Basic Information
Provider Information
NPI: 1265875728
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NI
FirstName: SIYUAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1750 EL CAMINO REAL STE 307
Address2:  
City: BURLINGAME
State: CA
PostalCode: 940103216
CountryCode: US
TelephoneNumber: 6506975367
FaxNumber:  
Practice Location
Address1: 1750 EL CAMINO REAL STE 307
Address2:  
City: BURLINGAME
State: CA
PostalCode: 940103216
CountryCode: US
TelephoneNumber: 6506975367
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/15/2013
LastUpdateDate: 04/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XA137311CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207R00000XA137311CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200XA137311CAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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