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NPI Code Detail

MEDICARE: FELY T ESCARA M.D.

MEDICARE: FELY T ESCARA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistA31231CA

General Provider Information

NPI Number : 1073559514
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELY T ESCARA M.D.
Provider Business Mailing Address
First Line : 25900 N HIGHWAY 99
Second Line :
City : ACAMPO
State : CA
Zip : 95220-9392
Country : US
Telephone Number : 209-339-9022
Fax Number : 209-339-9033
Provider Business Practice Location Address
First Line : 36 W YOKUTS AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95207-5713
Country : US
Telephone Number : 209-952-1189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/09/2014

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