Provider Demographics
NPI:1215289699
Name:QUINONEZ, GABRIEL
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:
Last Name:QUINONEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9095
Mailing Address - Street 2:1451 E. PLUTO ST.
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89060-9095
Mailing Address - Country:US
Mailing Address - Phone:775-209-2312
Mailing Address - Fax:
Practice Address - Street 1:1451 PLUTO ST
Practice Address - Street 2:1451 E. PLUTO ST.
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-6689
Practice Address - Country:US
Practice Address - Phone:775-209-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner