Healthcare Provider Details

I. General information

NPI: 1508730201
Provider Name (Legal Business Name): CARLOS QUESADA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 WILSHIRE BLVD STE 507
BEVERLY HILLS CA
90210-6150
US

IV. Provider business mailing address

9301 WILSHIRE BLVD STE 507
BEVERLY HILLS CA
90210-6150
US

V. Phone/Fax

Practice location:
  • Phone: 310-424-5750
  • Fax:
Mailing address:
  • Phone: 310-424-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS QUESADA
Title or Position: MD
Credential:
Phone: 310-424-5750