Provider Demographics
NPI:1578589271
Name:QUON, DORIS (MD)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:QUON
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 1:403 WEST ADAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90007-2664
Mailing Address - Country:US
Mailing Address - Phone:213-742-1000
Mailing Address - Fax:213-742-1435
Practice Address - Street 1:403 W ADAMS BLVD
Practice Address - Street 2:HEMOPHILIA TREATMENT CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2664
Practice Address - Country:US
Practice Address - Phone:213-742-1000
Practice Address - Fax:213-742-1103
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65707207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A65707Medicaid
WA64707AMedicare ID - Type Unspecified