Provider Demographics
NPI:1962089458
Name:UNDERHILL, DAVID QUINCEY
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:QUINCEY
Last Name:UNDERHILL
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 1:9131 OBSIDIAN DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-7333
Mailing Address - Country:US
Mailing Address - Phone:714-234-1350
Mailing Address - Fax:
Practice Address - Street 1:4320 MARICOPA ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4314
Practice Address - Country:US
Practice Address - Phone:310-303-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA179871208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation