Healthcare Provider Details

I. General information

NPI: 1306770094
Provider Name (Legal Business Name): MICHAEL STEVE QUIROZAYALA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 13TH ST BLDG 193
IMPERIAL BEACH CA
91932-3798
US

IV. Provider business mailing address

10027 RIO SAN DIEGO DR APT 209
SAN DIEGO CA
92108-5642
US

V. Phone/Fax

Practice location:
  • Phone: 619-437-9402
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: