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General NPI Number Information
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NPI Number | 1629197439
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Entity Type | Organization
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Legal Business Name | RUBENCIO QUINTANA, M.D. INC.
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 6310 SAN VICENTE BLVD STE 510
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City | LOS ANGELES
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State | CA
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Zip | 90048-5470
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Country | US
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Telephone | 310-659-5500
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Fax | 424-269-2166
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Provider Business Mailing Address
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Address Line | 6310 SAN VICENTE BLVD STE 510
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City | LOS ANGELES
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State | CA
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Zip | 90048-5470
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Country | US
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Telephone | 310-659-5500
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Fax | 424-269-2166
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Authorized Official
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Title or Position | OWNER
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Name | RUBENCIO QUINTANA
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Credential | MD
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Telephone | 310-659-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G77939
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License Number State | CA
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