Individual
MATTHEW QUIJANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
1143 MONACO CT, GROVER BEACH, CA 93433-3254
(805) 903-3616
Mailing address
1143 MONACO CT, GROVER BEACH, CA 93433-3254
(805) 903-3616
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000001554
CA
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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