Provider Demographics
NPI:1295989705
Name:QUIROGA, ADOLFO E (PA)
Entity type:Individual
Prefix:
First Name:ADOLFO
Middle Name:E
Last Name:QUIROGA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 70180
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92513-0180
Mailing Address - Country:US
Mailing Address - Phone:951-523-0117
Mailing Address - Fax:888-975-8926
Practice Address - Street 1:9939 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3528
Practice Address - Country:US
Practice Address - Phone:855-505-7467
Practice Address - Fax:888-975-8926
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA19098363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant