Provider Demographics
NPI:1881224160
Name:QUACINELLA ORTHOPAEDICS INC
Entity Type:Organization
Organization Name:QUACINELLA ORTHOPAEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUACINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MPH
Authorized Official - Phone:831-239-4736
Mailing Address - Street 1:4060 FOURTH AVE STE 630
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2118
Mailing Address - Country:US
Mailing Address - Phone:831-239-4736
Mailing Address - Fax:
Practice Address - Street 1:4060 FOURTH AVE STE 630
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2118
Practice Address - Country:US
Practice Address - Phone:619-299-3950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty