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General NPI Number Information
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NPI Number | 1306235247
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Entity Type | Individual
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Provider Name | JOHN QUIGLEY
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Gender | Male
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 11500 BROOKSHIRE AVE
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City | DOWNEY
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State | CA
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Zip | 90241-4917
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Country | US
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Telephone | 775-364-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 561 KEYSTONE AVE #414
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City | RENO
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State | NV
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Zip | 89503-4304
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 018365
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 52270
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 11825
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License Number State | MN
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