Provider Demographics
NPI:1790929255
Name:QUARTERMAN, RONALD ALEXANDER
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ALEXANDER
Last Name:QUARTERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7743 VICKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-5445
Mailing Address - Country:US
Mailing Address - Phone:818-399-5434
Mailing Address - Fax:818-884-7133
Practice Address - Street 1:6305 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2346
Practice Address - Country:US
Practice Address - Phone:818-909-3382
Practice Address - Fax:818-909-3383
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner