Provider Demographics
NPI:1821600800
Name:QUAN, BETTE
Entity Type:Individual
Prefix:
First Name:BETTE
Middle Name:
Last Name:QUAN
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 1:1200 GAVIOTA AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3889
Mailing Address - Country:US
Mailing Address - Phone:415-336-2318
Mailing Address - Fax:
Practice Address - Street 1:1200 GAVIOTA AVE APT 307
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3889
Practice Address - Country:US
Practice Address - Phone:415-336-2318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care