Provider Demographics
NPI:1922597566
Name:QUILARQUE GUKOVSKY, SOLCIET SOFIA DEL VALLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:SOLCIET
Middle Name:SOFIA DEL VALLE
Last Name:QUILARQUE GUKOVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 WEST PUTNAM AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257
Mailing Address - Country:US
Mailing Address - Phone:559-781-3700
Mailing Address - Fax:
Practice Address - Street 1:590 WEST PUTNAM AVENUE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257
Practice Address - Country:US
Practice Address - Phone:559-781-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2021-08-27
Deactivation Date:2018-12-19
Deactivation Code:
Reactivation Date:2019-01-23
Provider Licenses
StateLicense IDTaxonomies
CA173491208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics