Provider Demographics
NPI:1477764827
Name:QUAN, GLENDA GIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:GIA
Last Name:QUAN
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 1:499 E HAMPDEN AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3877
Mailing Address - Country:US
Mailing Address - Phone:303-788-5300
Mailing Address - Fax:
Practice Address - Street 1:499 E HAMPDEN AVE STE 380
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3877
Practice Address - Country:US
Practice Address - Phone:303-788-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLL16073390200000X
CO48192208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program