Provider Demographics
NPI:1073740825
Name:QUISMORIO, ANNE VIOLET (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:VIOLET
Last Name:QUISMORIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W SAN BERNARDINO RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3797
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 W SAN BERNARDINO RD
Practice Address - Street 2:SUITE A
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3797
Practice Address - Country:US
Practice Address - Phone:626-966-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108385207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine