Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A108385 | CA |
N | 111NI0900X | Internist | A108385 | CA |
Y | 207RR0500X | Rheumatology | A108385 | CA |
NPI | 1073740825 |
---|---|
Provider Name | Dr. Anne Violet Quismorio |
First Address | Covina, CA 91722-3797 |
Second Address | Covina, CA 91722-3797 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2009 |
Last Update Date | 01/11/2016 |