Healthcare Provider Details

I. General information

NPI: 1235818592
Provider Name (Legal Business Name): RICHARD HILTON ESTERWOLD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S CHEVY CHASE DR
GLENDALE CA
91205-4431
US

IV. Provider business mailing address

4082 CARLOTTA ST
SIMI VALLEY CA
93063-2807
US

V. Phone/Fax

Practice location:
  • Phone: 747-221-4197
  • Fax:
Mailing address:
  • Phone: 805-583-0653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: