Organization
E.VICENCIO-QUEVEDO M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARDITA E VICENCIO-QUEVEDO M.D. (PRESIDENT)
(818) 822-8317
Entity
Organization
Contact information
Practice address
709 E COLORADO BLVD, #160, PASADENA, CA 91101-2125
(818) 822-8317
(626) 793-7580
Mailing address
709 E COLORADO BLVD, #160, PASADENA, CA 91101-2125
(818) 822-8317
(626) 793-7580
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A23710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A237100
—
CA
Enumeration date
05/03/2007
Last updated
02/06/2009
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