Healthcare Provider Details

I. General information

NPI: 1851753115
Provider Name (Legal Business Name): MARTIN ESCANDON MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 11/18/2020
Certification Date: 11/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3052 WILLOW PASS RD
CONCORD CA
94519-2552
US

IV. Provider business mailing address

3052 WILLOW PASS RD # 2552
CONCORD CA
94519-2552
US

V. Phone/Fax

Practice location:
  • Phone: 925-681-4100
  • Fax:
Mailing address:
  • Phone: 925-681-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA150832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: