Provider Demographics
NPI:1528684461
Name:COOL QUIT, LLC.
Entity type:Organization
Organization Name:COOL QUIT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-762-5948
Mailing Address - Street 1:386 S BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5470
Mailing Address - Country:US
Mailing Address - Phone:408-762-5948
Mailing Address - Fax:
Practice Address - Street 1:386 S BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5470
Practice Address - Country:US
Practice Address - Phone:408-762-5948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care