Provider Demographics
NPI:1831832054
Name:QUEZON, ROSITA PAMINTUAN
Entity type:Individual
Prefix:
First Name:ROSITA
Middle Name:PAMINTUAN
Last Name:QUEZON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 E 64TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2802
Mailing Address - Country:US
Mailing Address - Phone:562-606-2258
Mailing Address - Fax:
Practice Address - Street 1:3360 E 64TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2802
Practice Address - Country:US
Practice Address - Phone:562-606-2258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider