Provider Demographics
NPI:1124141122
Name:QUION, AGNES G (MD)
Entity type:Individual
Prefix:DR
First Name:AGNES
Middle Name:G
Last Name:QUION
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:12677 HESPERIA RD
Mailing Address - Street 2:STE 120
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-7735
Mailing Address - Country:US
Mailing Address - Phone:760-951-5938
Mailing Address - Fax:760-951-5948
Practice Address - Street 1:12677 HESPERIA RD
Practice Address - Street 2:STE 120
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7735
Practice Address - Country:US
Practice Address - Phone:760-951-5938
Practice Address - Fax:760-951-5948
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2010-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA52515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A525150Medicaid
CA00A525150Medicare ID - Type Unspecified
CAF19805Medicare UPIN