Healthcare Provider Details

I. General information

NPI: 1558366583
Provider Name (Legal Business Name): ARTURO QUINTANILLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 900 BOB HOPE DRIVE SUITE 140
RANCHO MIRAGE CA
92270
US

IV. Provider business mailing address

35900 BOB HOPE DR SUITE 140
RANCHO MIRAGE CA
92270-1766
US

V. Phone/Fax

Practice location:
  • Phone: 760-770-0000
  • Fax: 760-770-2727
Mailing address:
  • Phone: 760-770-0000
  • Fax: 760-770-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA-048139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: