Healthcare Provider Details

I. General information

NPI: 1710376793
Provider Name (Legal Business Name): RODRIGO ESGUERRA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 E WILSHIRE AVE
FULLERTON CA
92832-1935
US

IV. Provider business mailing address

245 E WILSHIRE AVE
FULLERTON CA
92832-1935
US

V. Phone/Fax

Practice location:
  • Phone: 714-871-6020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: