Healthcare Provider Details

I. General information

NPI: 1285928853
Provider Name (Legal Business Name): JEFFREY EUGENE QUIGLEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 ATLANTIC AVE
LONG BEACH CA
90813-3408
US

IV. Provider business mailing address

3555 TAYLOR DR
PALM SPRINGS CA
92262-0477
US

V. Phone/Fax

Practice location:
  • Phone: 562-432-7175
  • Fax: 562-432-7107
Mailing address:
  • Phone: 706-267-9776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number12360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: