Ediltrodito Paez Quianzon, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C51122 Issued in CA

Practice address

13193 Central Ave
Suite 100
Chino, CA 91710-3522

Phone

(909) 464-9675

Fax

(909) 590-3898

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952407736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103522",
            "telephone_number": "909-464-9675",
            "fax_number": "909-590-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103522",
            "telephone_number": "909-464-9675",
            "fax_number": "909-590-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIANZON",
        "first_name": "EDILTRODITO",
        "middle_name": "PAEZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C51122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Chino, CA
• Providers in Chino, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.