Provider Demographics
NPI:1730346925
Name:QUON, DANIEL E (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:QUON
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:949 SOUTH COAST DRIVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7838
Mailing Address - Country:US
Mailing Address - Phone:714-540-2020
Mailing Address - Fax:714-540-5844
Practice Address - Street 1:949 SOUTH COAST DRIVE
Practice Address - Street 2:SUITE 155
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:714-540-2020
Practice Address - Fax:714-540-5844
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CACA05749T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU38003Medicare UPIN