Provider Demographics
NPI:1497080857
Name:MA, QUANG (DO)
Entity Type:Individual
Prefix:
First Name:QUANG
Middle Name:
Last Name:MA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:24715 TIBURON ST
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:661-480-2377
Mailing Address - Fax:661-480-2378
Practice Address - Street 1:38420 5TH STREET WEST
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551
Practice Address - Country:US
Practice Address - Phone:661-480-2377
Practice Address - Fax:661-480-2378
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2016-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A11530207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery