Provider Demographics
NPI:1538240270
Name:QUINTAL-DISCIPULO, FAYE ANTOINETTE
Entity type:Individual
Prefix:MS
First Name:FAYE
Middle Name:ANTOINETTE
Last Name:QUINTAL-DISCIPULO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FAYE
Other - Middle Name:ANTOINETTE
Other - Last Name:QUINTAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15709 SEAFORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-7366
Mailing Address - Country:US
Mailing Address - Phone:562-229-3083
Mailing Address - Fax:562-229-3083
Practice Address - Street 1:1925 DALY ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-3309
Practice Address - Country:US
Practice Address - Phone:323-226-1393
Practice Address - Fax:323-223-8380
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner