Healthcare Provider Details

I. General information

NPI: 1053416958
Provider Name (Legal Business Name): RODOLFO QUINTERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 06/12/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E COLORADO ST # 400
GLENDALE CA
91205-1607
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD # 95390
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 818-230-7778
  • Fax: 888-873-4727
Mailing address:
  • Phone: 818-230-7778
  • Fax: 818-484-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberA75426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: