Healthcare Provider Details

I. General information

NPI: 1326542457
Provider Name (Legal Business Name): MORGAN QUEZADA-LOPEZ MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN QUEZADA MD, MPH

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 WILSHIRE BLVD
LOS ANGELES CA
90095-1197
US

IV. Provider business mailing address

6210 BRISTOL PKWY APT 309
CULVER CITY CA
90230-6936
US

V. Phone/Fax

Practice location:
  • Phone: 213-977-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number310563
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA177210
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA177210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: