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General NPI Number Information
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NPI Number | 1104195023
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Entity Type | Individual
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Provider Name | DANIEL BRIAN QUAN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 5913 CARSON ST
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City | LAKEWOOD
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State | CA
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Zip | 90713-3104
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Country | US
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Telephone | 562-429-9120
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Fax | 562-429-8340
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Provider Business Mailing Address
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Address Line | 12286 BRIDGEWATER WAY
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City | SEAL BEACH
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State | CA
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Zip | 90740-2775
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Country | US
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Telephone | 562-430-4847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 45719
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License Number State | CA
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