Provider Demographics
NPI:1801081906
Name:QUAN, PATRICIA DOLORES (NP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DOLORES
Last Name:QUAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19323 DERBYSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7221
Mailing Address - Country:US
Mailing Address - Phone:310-222-4004
Mailing Address - Fax:310-222-4006
Practice Address - Street 1:1000 W CARSON ST # 491
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-4004
Practice Address - Fax:310-222-4006
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375730363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics