Provider Demographics
NPI:1306875125
Name:QUADE, RITA B (MD)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:B
Last Name:QUADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:A
Other - Last Name:GRASSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:175 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2913
Mailing Address - Country:US
Mailing Address - Phone:530-661-4410
Mailing Address - Fax:530-661-4403
Practice Address - Street 1:175 W COURT ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2913
Practice Address - Country:US
Practice Address - Phone:530-661-4410
Practice Address - Fax:530-661-4403
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52664207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A52316Medicare UPIN