Provider Demographics
NPI:1639944366
Name:QUIMBY, MALAYSIA
Entity Type:Individual
Prefix:
First Name:MALAYSIA
Middle Name:
Last Name:QUIMBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5461 YARMOUTH AVE APT 53
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2337
Mailing Address - Country:US
Mailing Address - Phone:323-470-8847
Mailing Address - Fax:
Practice Address - Street 1:5461 YARMOUTH AVE APT 53
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2337
Practice Address - Country:US
Practice Address - Phone:323-470-8847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula