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General NPI Number Information
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NPI Number | 1639218340
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Entity Type | Individual
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Provider Name | EARLA E QUISIDO MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 2105 BEVERLY BLVD STE 213
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City | LOS ANGELES
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State | CA
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Zip | 90057-2272
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Country | US
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Telephone | 213-483-8300
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Fax | 213-483-8088
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Provider Business Mailing Address
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Address Line | PO BOX 9723
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City | GLENDALE
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State | CA
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Zip | 91226-0723
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Country | US
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Telephone | 213-483-8300
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Fax | 213-483-8088
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A481003
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License Number State | CA
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