Provider Demographics
NPI:1982652277
Name:QUON, JOANN UYEMARUKO (NP)
Entity Type:Individual
Prefix:MR
First Name:JOANN
Middle Name:UYEMARUKO
Last Name:QUON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 KATHY WAY
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-5433
Mailing Address - Country:US
Mailing Address - Phone:310-792-8317
Mailing Address - Fax:
Practice Address - Street 1:601 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3416
Practice Address - Country:US
Practice Address - Phone:310-792-8317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN226695363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health