Provider Demographics
NPI:1467576421
Name:QUINONES, JAMES WILLIAM (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:QUINONES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14514 RAMONA BOULVEVARD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BALDWINPARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706
Mailing Address - Country:US
Mailing Address - Phone:626-337-0424
Mailing Address - Fax:626-813-9095
Practice Address - Street 1:14514 RAMONA BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3305
Practice Address - Country:US
Practice Address - Phone:626-337-0424
Practice Address - Fax:626-813-9095
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12379208000000X
CAPA 12379363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics