Healthcare Provider Details

I. General information

NPI: 1619035797
Provider Name (Legal Business Name): EVA S. QUIROZ, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MOWRY AVE
FREMONT CA
94538-1716
US

IV. Provider business mailing address

1028 AVILA TERRAZA
FREMONT CA
94538-4601
US

V. Phone/Fax

Practice location:
  • Phone: 510-402-3424
  • Fax:
Mailing address:
  • Phone: 510-790-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberG86961
License Number StateCA

VIII. Authorized Official

Name: DR. EVA S QUIROZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 510-790-2897