Provider Demographics
NPI:1437121415
Name:LAQUI, ELIZABETH CARANDANG (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CARANDANG
Last Name:LAQUI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:CARANDANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:498 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2070
Mailing Address - Country:US
Mailing Address - Phone:951-943-8899
Mailing Address - Fax:
Practice Address - Street 1:498 W 4TH ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2070
Practice Address - Country:US
Practice Address - Phone:951-943-8899
Practice Address - Fax:951-943-4598
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39839208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
A88500Medicare UPIN