Provider Demographics
NPI:1134216559
Name:QUON, DAVID K (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:QUON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:808 N HILL ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2321
Mailing Address - Country:US
Mailing Address - Phone:213-680-0456
Mailing Address - Fax:626-300-9280
Practice Address - Street 1:808 N HILL ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2321
Practice Address - Country:US
Practice Address - Phone:213-680-0456
Practice Address - Fax:626-300-9280
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2013-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG45546207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G455460Medicaid
CA00G455460Medicaid
CAG45546Medicare PIN