Healthcare Provider Details

I. General information

NPI: 1942223201
Provider Name (Legal Business Name): EAST BAY MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105B LOTTIE LANE
FAIRHOPE AL
36532
US

IV. Provider business mailing address

105B LOTTIE LANE
FAIRHOPE AL
36532
US

V. Phone/Fax

Practice location:
  • Phone: 251-990-7330
  • Fax: 251-990-7331
Mailing address:
  • Phone: 251-990-7330
  • Fax: 251-990-7331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCISCO J. QUINONES
Title or Position: PRESIDENT
Credential: MD
Phone: 251-990-7330