Basic Information
Provider Information
NPI: 1215247879
EntityType: 2
ReplacementNPI:  
OrganizationName: PAULINA G QUINTANA M D INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: PATHOLOGY ASSOCIATES OF NATIONAL CITY
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10076
Address2:  
City: VAN NUYS
State: CA
PostalCode: 914100076
CountryCode: US
TelephoneNumber: 8055788300
FaxNumber: 8055783911
Practice Location
Address1: 2400 E 4TH STREET
Address2:  
City: NATIONAL CITY
State: CA
PostalCode: 91950
CountryCode: US
TelephoneNumber: 6194704175
FaxNumber: 6194724598
Other Information
ProviderEnumerationDate: 10/18/2010
LastUpdateDate: 10/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: QUINTANA
AuthorizedOfficialFirstName: PAULINA
AuthorizedOfficialMiddleName: G
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 6194704175
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X05D0568044CAY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


Home