Healthcare Provider Details

I. General information

NPI: 1730029117
Provider Name (Legal Business Name): RUDY ESAU MARCHORRO JR CPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17434 BELLFLOWER BLVD STE 200-243
BELLFLOWER CA
90706-6849
US

IV. Provider business mailing address

10921 OTIS ST
LYNWOOD CA
90262-2150
US

V. Phone/Fax

Practice location:
  • Phone: 310-926-1235
  • Fax:
Mailing address:
  • Phone: 310-926-1235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: