Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | C161493 | CA |
NPI | 1073511432 |
---|---|
Provider Name | Dr. Ricardo J. Quintero |
First Address | Cerritos, CA 90703-2671 |
Second Address | Cerritos, CA 90703-2671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 23/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1087226 | WELLCARE (01) | FL |
17336 | BCBS (01) | FL |
264422300 | (05) | FL |
330467 | AVMED (01) | FL |
4171740 | CIGNA/GREAT WEST (01) | FL |
4468097 | CONCENTRA/FOCUS THRU KEYS PHA (01) | FL |
7234314 | AETNA (01) | FL |
E7051S | MEDICARE (01) | FL |
H56335 | (02) | FL |
P01462033 | RAILROAD MEDICARE (01) | FL |
PRV0010410 | PREFFERED MEDICAL PLAN (01) | FL |