Healthcare Provider Details

I. General information

NPI: 1760832018
Provider Name (Legal Business Name): MARKUS BRIAN QUINN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD CHILDREN'S HOSPITAL LOS ANGELES
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

1520 RODNEY DR APT 407
LOS ANGELES CA
90027-5338
US

V. Phone/Fax

Practice location:
  • Phone: 323-660-2450
  • Fax:
Mailing address:
  • Phone: 914-960-2946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number143033
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: