Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G47637 | CA |
NPI | 1003163940 |
---|---|
Provider Name | Dr. Jeffrey Quitman |
First Address | Huntington Beach, CA 92648-6827 |
Second Address | Huntington Beach, CA 92648-6827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2012 |
Last Update Date | 09/08/2012 |