Provider Demographics
NPI:1700949716
Name:QUANT, ALFONSO ANTONIO (PA)
Entity Type:Individual
Prefix:
First Name:ALFONSO
Middle Name:ANTONIO
Last Name:QUANT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 SILVER CLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:GOLD RIVER
Mailing Address - State:CA
Mailing Address - Zip Code:95670-8398
Mailing Address - Country:US
Mailing Address - Phone:916-852-9655
Mailing Address - Fax:
Practice Address - Street 1:7501 HOSPITAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5405
Practice Address - Country:US
Practice Address - Phone:916-681-1130
Practice Address - Fax:916-681-1133
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12478363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical