Provider Demographics
NPI:1013193671
Name:HAROLD E. QUAN, M.D., INC
Entity Type:Organization
Organization Name:HAROLD E. QUAN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:6691-255-8320
Mailing Address - Street 1:23928 LYONS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2409
Mailing Address - Country:US
Mailing Address - Phone:661-255-8320
Mailing Address - Fax:661-255-0338
Practice Address - Street 1:23845 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2001
Practice Address - Country:US
Practice Address - Phone:661-255-8320
Practice Address - Fax:661-255-8320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34182207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A341820Medicaid
ZZZ57676ZOtherBLUE SHIELD
CA00A341820Medicaid