Provider Demographics
NPI:1679503593
Name:QUAN, CHERINE K (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHERINE
Middle Name:K
Last Name:QUAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 LADERA ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-2133
Mailing Address - Country:US
Mailing Address - Phone:626-277-5250
Mailing Address - Fax:
Practice Address - Street 1:2130 REDONDO BEACH BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-1673
Practice Address - Country:US
Practice Address - Phone:310-768-8281
Practice Address - Fax:310-768-8399
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice