Healthcare Provider Details

I. General information

NPI: 1295998318
Provider Name (Legal Business Name): OSCAR ESQUEDA JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2281 W 24TH ST STE 4
YUMA AZ
85364-6154
US

IV. Provider business mailing address

2281 W 24TH ST STE 4
YUMA AZ
85364-6154
US

V. Phone/Fax

Practice location:
  • Phone: 928-726-6592
  • Fax:
Mailing address:
  • Phone: 928-726-6592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3395
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: