Provider Demographics
NPI:1932655743
Name:QUIAMBAO, SETH ROWEL
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:ROWEL
Last Name:QUIAMBAO
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 1:16919 JUDY WAY
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2864
Mailing Address - Country:US
Mailing Address - Phone:562-290-9232
Mailing Address - Fax:
Practice Address - Street 1:16919 JUDY WAY
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2864
Practice Address - Country:US
Practice Address - Phone:562-290-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA606042163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine