Individual provider Active NPI

Marvin John Quines

  • Registered Nurse
  • Grand Terrace, CA
National Provider Identifier
1700778750
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95424991 Issued in CA
Practice address
11844 Greenbrier LN
Grand Terrace, CA 92313-8341
Phone
(424) 333-5590
NPI assigned
Jul 16, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95424991 CA Primary

Addresses

Primary practice location

11844 Greenbrier LN
Grand Terrace, CA 92313-8341

Mailing address

11844 Greenbrier LN
Grand Terrace, CA 92313-8341
Phone (424) 333-5590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95424991CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1700778750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11844 GREENBRIER LN",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923138341",
            "telephone_number": "424-333-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11844 GREENBRIER LN",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923138341",
            "telephone_number": "424-333-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINES",
        "first_name": "MARVIN",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95424991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.