Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | A126272 | CA |
NPI | 1124375233 |
---|---|
Provider Name | Hector David Quintanilla |
First Address | Harbor City, CA 90710-3518 |
Second Address | Harbor City, CA 90710-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2012 |
Last Update Date | 14/12/2021 |