Quismorio, Demetrio Ortiz

Quismorio, Demetrio Ortiz is an individual health care provider with primary practice located at 341 Magnolia Ave Suite 101, Corona CA 92879-3330. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Quismorio, Demetrio Ortiz can be contacted via phone (951) 735-6060.

Contact Information

Primary practice address
341 Magnolia Ave Suite 101 Corona CA 92879-3330
Phone: (951) 735-6060
Fax: (951) 735-4510
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA14870 California

Profile Details

NPI number 1760493191
LBN Legal business name Quismorio, Demetrio Ortiz
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated May 9th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760493191 NPPES
California MEDICAID 0PA148700
California Other 970008971

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