Basic Information
| Provider Information | |||||||||
| NPI: | 1861758476 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BACA | ||||||||
| FirstName: | QUENTIN | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7999 GATEWAY BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945601197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108062950 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 300 PASTEUR DR | ||||||||
| Address2: | GRANT S101 | ||||||||
| City: | STANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943055109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236661 | ||||||||
| FaxNumber: | 6504986205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2012 | ||||||||
| LastUpdateDate: | 08/29/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A126544 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.