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Individual
DR. PHYLLIS QUINTANA
Active
Individual
DR. PHYLLIS QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5585TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116524
EYE MED
—
01
—
500055850
MEDICAL
—
01
—
6648
GOLDEN WEST
—
01
—
6701
MEDICAL EYE SERVICES
—
01
—
953833691
VSP
—
Enumeration date
08/18/2006
Last updated
12/30/2011
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