Healthcare Provider Details

I. General information

NPI: 1255448726
Provider Name (Legal Business Name): KATHERINE QUINTANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 SAND CANYON AVE STE 506
IRVINE CA
92618-3711
US

IV. Provider business mailing address

210 N TUSTIN AVE
SANTA ANA CA
92705-3807
US

V. Phone/Fax

Practice location:
  • Phone: 949-753-6070
  • Fax:
Mailing address:
  • Phone: 714-347-1000
  • Fax: 714-647-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG76515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: