Healthcare Provider Details

I. General information

NPI: 1942483417
Provider Name (Legal Business Name): MS. GABRIELA ESCANDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WEST WOODWARD AVENUE
ALHAMBRA CA
91801
US

IV. Provider business mailing address

9150 EAST IMPERIAL HIGHWAY ROOM P31
DOWNEY CA
90242
US

V. Phone/Fax

Practice location:
  • Phone: 626-308-5266
  • Fax: 626-308-5287
Mailing address:
  • Phone: 562-940-3694
  • Fax: 562-658-4725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: