Healthcare Provider Details

I. General information

NPI: 1134483563
Provider Name (Legal Business Name): BRIAN QUIRANTE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 JUNE DR
CORONA CA
92879-5964
US

IV. Provider business mailing address

767 JUNE DR
CORONA CA
92879-5964
US

V. Phone/Fax

Practice location:
  • Phone: 951-751-9058
  • Fax:
Mailing address:
  • Phone: 951-751-9058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number66190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: