Provider Demographics
NPI:1962738864
Name:HEALTH QUEST
Entity type:Organization
Organization Name:HEALTH QUEST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-583-3200
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR STE 301
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1735
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:888-652-3017
Practice Address - Street 1:2677 ZOE AVE STE 114
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6995
Practice Address - Country:US
Practice Address - Phone:323-583-3200
Practice Address - Fax:323-583-3500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH QUEST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-27
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5635923OtherNPDS NUMBER