Provider Demographics
NPI:1083667646
Name:CHING, QUIMBO GULAY (MD)
Entity Type:Individual
Prefix:
First Name:QUIMBO
Middle Name:GULAY
Last Name:CHING
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 1:81833 DR CARREON BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5590
Mailing Address - Country:US
Mailing Address - Phone:760-775-7763
Mailing Address - Fax:760-775-9953
Practice Address - Street 1:81833 DR CARREON BLVD STE 6
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5590
Practice Address - Country:US
Practice Address - Phone:760-775-7763
Practice Address - Fax:760-775-9953
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-068065208000000X
CAC134912208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL367830OtherPEDIATRICS
C47653Medicare UPIN