Provider Demographics
NPI:1730243320
Name:QUINONES, ROY (MD)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 90TH ST
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-1807
Mailing Address - Country:US
Mailing Address - Phone:650-301-8600
Mailing Address - Fax:650-301-8626
Practice Address - Street 1:380 90TH ST
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1807
Practice Address - Country:US
Practice Address - Phone:650-301-8600
Practice Address - Fax:650-301-8626
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81287207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A812870Medicare ID - Type Unspecified
I26035Medicare UPIN