Individual
DR. JORGE ANTONIO QUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4644 LINCOLN BLVD STE 410, MARINA DEL REY, CA 90292-6390
(310) 823-6766
(310) 823-6966
Mailing address
4644 LINCOLN BLVD STE 410, MARINA DEL REY, CA 90292-6390
(310) 823-6766
(310) 823-6966
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A24556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A24556
MEDICAL LICENSURE
CA
Enumeration date
03/02/2007
Last updated
07/08/2007
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