Healthcare Provider Details

I. General information

NPI: 1790758662
Provider Name (Legal Business Name): ROMEO ESQUIVEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 N LA CHOLLA BLVD SUITE 210
TUCSON AZ
85741-3557
US

IV. Provider business mailing address

PO BOX 43130
TUCSON AZ
85733-3130
US

V. Phone/Fax

Practice location:
  • Phone: 520-575-5003
  • Fax: 520-297-3146
Mailing address:
  • Phone: 520-722-3777
  • Fax: 520-296-6224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number29123
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: