Provider Demographics
NPI:1679269757
Name:QUIROZ, ELAINE MARIE
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:MARIE
Last Name:QUIROZ
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 1:519 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-3309
Mailing Address - Country:US
Mailing Address - Phone:559-395-8011
Mailing Address - Fax:
Practice Address - Street 1:519 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-3309
Practice Address - Country:US
Practice Address - Phone:559-395-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)