Healthcare Provider Details

I. General information

NPI: 1982652277
Provider Name (Legal Business Name): JOANN UYEMARUKO QUON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 TORRANCE BLVD
REDONDO BEACH CA
90277-3416
US

IV. Provider business mailing address

2048 KATHY WAY
TORRANCE CA
90501-5433
US

V. Phone/Fax

Practice location:
  • Phone: 310-792-8317
  • Fax:
Mailing address:
  • Phone: 310-792-8317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN226695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: