Provider Demographics
NPI:1861436024
Name:QUIST, RICHARD G (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:QUIST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:361 HOSPITAL RD
Mailing Address - Street 2:SUITE 331
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3522
Mailing Address - Country:US
Mailing Address - Phone:949-650-8700
Mailing Address - Fax:949-650-0877
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:SUITE 331
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3522
Practice Address - Country:US
Practice Address - Phone:949-650-8700
Practice Address - Fax:949-650-0877
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA65910207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A659100Medicaid
CA00A659100Medicaid
CAW15325Medicare ID - Type Unspecified