Provider Demographics
NPI:1700591948
Name:ANNA-LIA G QUINIO MD INC
Entity type:Organization
Organization Name:ANNA-LIA G QUINIO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-222-7794
Mailing Address - Street 1:45-955 KAMEHAMEHA HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3292
Mailing Address - Country:US
Mailing Address - Phone:808-234-6383
Mailing Address - Fax:
Practice Address - Street 1:45-955 KAMEHAMEHA HWY STE 300
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3292
Practice Address - Country:US
Practice Address - Phone:808-745-0789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty