Healthcare Provider Details

I. General information

NPI: 1386941516
Provider Name (Legal Business Name): FRANCISCO P. QUISMORIO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST LA COUNTY USC MEDICAL CENTER
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

2011 ZONAL AVE USC KECK SCHOOL OF MEDICINE HMR711
LOS ANGELES CA
90089-0110
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-7874
  • Fax: 323-226-4224
Mailing address:
  • Phone: 323-442-1946
  • Fax: 323-442-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0001X
TaxonomyClinical & Laboratory Immunology (Internal Medicine) Physician
License NumberA024976
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA024976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: