Healthcare Provider Details
I. General information
NPI: 1083857627
Provider Name (Legal Business Name): DAVID J. QUINTANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/13/2009
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10800 E GEDDES AVE STE 300
ENGLEWOOD CO
80112-3895
US
IV. Provider business mailing address
10800 E GEDDES AVE STE 300
ENGLEWOOD CO
80112-3895
US
V. Phone/Fax
- Phone: 303-761-9190
- Fax: 720-874-4462
- Phone: 303-761-9190
- Fax: 720-874-4462
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | ME-114454 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | Q3424 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | DR.0071757 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: