Provider Demographics
NPI:1356635478
Name:GONZALEZ QUESADA, CARLOS JOAQUIN (MD, MPH, FACC, FSCAI)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JOAQUIN
Last Name:GONZALEZ QUESADA
Suffix:
Gender:M
Credentials:MD, MPH, FACC, FSCAI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6260 W 3RD ST APT 430
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-7611
Mailing Address - Country:US
Mailing Address - Phone:713-254-9880
Mailing Address - Fax:888-299-8621
Practice Address - Street 1:414 N CAMDEN DR STE 1100
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4517
Practice Address - Country:US
Practice Address - Phone:713-254-9880
Practice Address - Fax:888-299-8621
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA128997207R00000X, 207RC0000X, 207RI0011X
MA261106207R00000X
MN62315207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease