Provider Demographics
NPI:1700778750
Name:QUINES, MARVIN JOHN
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:JOHN
Last Name:QUINES
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 1:11844 GREENBRIER LN
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-8341
Mailing Address - Country:US
Mailing Address - Phone:424-333-5590
Mailing Address - Fax:
Practice Address - Street 1:11844 GREENBRIER LN
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-8341
Practice Address - Country:US
Practice Address - Phone:424-333-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95424991163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse