Provider Demographics
NPI:1043249584
Name:QUINN, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-865-3956
Mailing Address - Fax:
Practice Address - Street 1:1441 EASTLAKE AVE STE 3440
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0112
Practice Address - Country:US
Practice Address - Phone:323-865-3956
Practice Address - Fax:323-865-0061
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86796207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00F476600Medicaid
CAW11675OtherGROUP MEDICARE PIN
CAW18762OtherGROUP MEDICARE
CA1356390009OtherGROUP NPI
CA900003436OtherRAILROAD MEDICARE
CACE1617OtherGROUP RAILROAD MEDICARE
CA00F476600OtherBLUE SHIELD
CA1902846306OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CAGR0016910OtherGROUP MEDICAID PIN
CAGR0100430OtherGROUP MEDICAL
CAW11675OtherGROUP MEDICARE PIN