Provider Demographics
NPI:1578573697
Name:ALMOND, QUINCY (MD)
Entity Type:Individual
Prefix:
First Name:QUINCY
Middle Name:
Last Name:ALMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:877-608-0044
Mailing Address - Fax:877-514-0903
Practice Address - Street 1:1310 W STEWART DR
Practice Address - Street 2:STE 410
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-639-9401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91842208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00719635OtherRAIL ROAD MEDICARE - PROVIDER PTAN
1912919804OtherNPI - TYPE 2
CAA91842OtherST. LICENSE
CACG5665OtherRAIL ROAD MEDICARE - GROUP PTAN
CAW1514OtherMEDICARE PTAN - TYPE 2
CACG5665OtherRAIL ROAD MEDICARE - GROUP PTAN