Healthcare Provider Details

I. General information

NPI: 1962740159
Provider Name (Legal Business Name): CATALINA G. ESCOBAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 FOURTH AVENUE SUITE 408
CHULA VISTA CA
91910-4430
US

IV. Provider business mailing address

450 FOURTH AVENUE SUITE 408
CHULA VISTA CA
91910-4430
US

V. Phone/Fax

Practice location:
  • Phone: 619-691-1991
  • Fax: 619-691-5977
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: CATALINA G. ESCOBAR
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 619-691-1990