Basic Information
| Provider Information | |||||||||
| NPI: | 1790929255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUARTERMAN | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | ALEXANDER | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7743 VICKY AVE | ||||||||
| Address2: | |||||||||
| City: | WEST HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913045445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183995434 | ||||||||
| FaxNumber: | 8188847133 | ||||||||
| Practice Location | |||||||||
| Address1: | 6305 WOODMAN AVE | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914012346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189093382 | ||||||||
| FaxNumber: | 8189093383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2009 | ||||||||
| LastUpdateDate: | 02/23/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.