Healthcare Provider Details

I. General information

NPI: 1891039640
Provider Name (Legal Business Name): MR. ROBERTO MIGUEL ESPANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBERTO MIGUEL ESPANA R.N.D.

II. Dates (important events)

Enumeration Date: 11/17/2012
Last Update Date: 11/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W SHAW AVE SUITE 404
FRESNO CA
93711-3501
US

IV. Provider business mailing address

1500 W SHAW AVE SUITE 404
FRESNO CA
93711-3501
US

V. Phone/Fax

Practice location:
  • Phone: 559-225-0356
  • Fax: 559-230-0972
Mailing address:
  • Phone: 559-225-0356
  • Fax: 559-230-0972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberRND200045
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: