Healthcare Provider Details

I. General information

NPI: 1730738022
Provider Name (Legal Business Name): QRS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 ALTON PKWY
IRVINE CA
92618-3734
US

IV. Provider business mailing address

25372 BOWSPRIT DR
DANA POINT CA
92629-1419
US

V. Phone/Fax

Practice location:
  • Phone: 949-932-5000
  • Fax:
Mailing address:
  • Phone: 909-528-9374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEJANDRO MANRIQUE
Title or Position: OWNER/MANAGER
Credential: RT
Phone: 909-528-9374