Jack Querequincia
NPI #1376544114 in Simi Valley, California
Provider Information
- NPI Number
- 1376544114
- Entity Type
- Organization
- Organization Name
- Jack Querequincia
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Aug 2, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2375 SYCAMORE DR
- Address 2
- SUITE 4
- City
- Simi Valley
- State
- California
- ZIP Code
- 93065-2787
- Phone
- (805) 581-5905
Authorized Official
- Name
- JACK DANIEL QUEREQUINCIA
- Title
- OWNER
- Phone
- (805) 581-5905
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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