Individual
MISS OLHA K QUINTERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 S FAIRMONT AVE, LODI, CA 95240-5116
(209) 333-1884
Mailing address
815 S FAIRMONT AVE, LODI, CA 95240-5116
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
59408
CA
363AS0400X
Surgical Physician Assistant
Primary
59408
CA
Other
Enumeration date
10/25/2019
Last updated
12/10/2025
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