MEDICARE: MR. DANIEL QUESADA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	126184	CA

General Provider Information

NPI Number	:	1366777195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL QUESADA M.D.

Provider Business Mailing Address
First Line	:	510 PINE GARDEN LN APT A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-5514
Country	:	US
Telephone Number	:	562-862-2737
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 PINE GARDEN LN APT A
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-5514
Country	:	US
Telephone Number	:	562-862-2737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	11/06/2015

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