Provider Demographics
NPI:1215765292
Name:QUIROZ, MIGUEL ANGEL VALENTINO III (DACM, CMQP, LMT)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL VALENTINO
Last Name:QUIROZ
Suffix:III
Gender:M
Credentials:DACM, CMQP, LMT
Other - Prefix:
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Mailing Address - Street 1:1389 JEFFERSON ST UNIT D208
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1854
Mailing Address - Country:US
Mailing Address - Phone:415-408-8800
Mailing Address - Fax:
Practice Address - Street 1:15A HENRY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1214
Practice Address - Country:US
Practice Address - Phone:415-408-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-30051225700000X
CA71008225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist