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General NPI Number Information
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NPI Number | 1720198666
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Entity Type | Individual
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Provider Name | JAVIER QUINTANA MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 1529 E PALMDALE BLVD STE 150
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City | PALMDALE
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State | CA
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Zip | 93550-2038
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Country | US
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Telephone | 213-219-3875
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Fax |
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Provider Business Mailing Address
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Address Line | 2692 BASIL LN
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City | LOS ANGELES
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State | CA
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Zip | 90077-2006
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Country | US
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Telephone | 310-991-3711
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A53465
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License Number State | CA
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