Healthcare Provider Details

I. General information

NPI: 1811062755
Provider Name (Legal Business Name): CLAUDIA QUIJANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 SHOTWELL ST
SAN FRANCISCO CA
94110-1323
US

IV. Provider business mailing address

240 SHOTWELL ST
SAN FRANCISCO CA
94110-1323
US

V. Phone/Fax

Practice location:
  • Phone: 415-552-1013
  • Fax: 415-431-3178
Mailing address:
  • Phone: 415-552-1013
  • Fax: 415-431-3178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50918
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: