Provider Demographics
NPI:1851868343
Name:QUAN, ROLAND (DC)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:
Last Name:QUAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 WOODCREEK LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-3440
Mailing Address - Country:US
Mailing Address - Phone:301-806-9361
Mailing Address - Fax:
Practice Address - Street 1:1101 SOUTH WINCHESTER BLVD
Practice Address - Street 2:D-138
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-394-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor