Healthcare Provider Details
I. General information
NPI: 1437355534
Provider Name (Legal Business Name): EMAD ELQUZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2007
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 THE CITY DR S
ORANGE CA
92868-3201
US
IV. Provider business mailing address
200 S MANCHESTER AVE STE 300
ORANGE CA
92868-3219
US
V. Phone/Fax
- Phone: 714-456-8000
- Fax:
- Phone: 714-456-2986
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | C167835 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | C167835 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: