Healthcare Provider Details

I. General information

NPI: 1235583410
Provider Name (Legal Business Name): JOEL QUIJANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 10/16/2023
Certification Date: 04/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 WALKER ST
LA PALMA CA
90623-1722
US

IV. Provider business mailing address

2040 S SANTA CRUZ ST STE 215
ANAHEIM CA
92805-6821
US

V. Phone/Fax

Practice location:
  • Phone: 714-670-7400
  • Fax:
Mailing address:
  • Phone: 714-577-2124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA158027
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA158027
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.134815
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: