Basic Information
| Provider Information | |||||||||
| NPI: | 1912403163 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZHOU | ||||||||
| FirstName: | QINWEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ZHOU | ||||||||
| OtherFirstName: | JENNY | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 315 SOUTH COAST HIGHWAY 101 | ||||||||
| Address2: | SUITE U#179 | ||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602302251 | ||||||||
| FaxNumber: | 7602302251 | ||||||||
| Practice Location | |||||||||
| Address1: | 662 ENCINITAS BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920246791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7602302251 | ||||||||
| FaxNumber: | 7606337879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2018 | ||||||||
| LastUpdateDate: | 05/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A164101 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.