Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 95000091 | CA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 95000091 | CA |
NPI | 1013320134 |
---|---|
Provider Name | Mr. Richard Quitevis |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2014 |
Last Update Date | 08/06/2016 |