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General NPI Number Information
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NPI Number | 1417980186
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Entity Type | Organization
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Legal Business Name | DANIEL E. QUON, O.D. INC.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 949 S COAST DR SUITE 155
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City | COSTA MESA
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State | CA
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Zip | 92626-7737
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Country | US
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Telephone | 714-540-2020
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Fax | 714-540-5844
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Provider Business Mailing Address
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Address Line | 949 SOUTH COAST DRIVE SUITE 155
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City | COSTA MESA
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State | CA
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Zip | 92626-7737
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Country | US
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Telephone | 714-540-2020
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Fax | 714-540-5844
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. DANIEL EUGENE QUON
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Credential | O.D.
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Telephone | 714-540-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | CA 05749T
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License Number State | CA
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