Healthcare Provider Details

I. General information

NPI: 1306787254
Provider Name (Legal Business Name): ANGEL DAVID ESPARZA RIOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 IRIS AVE
IMPERIAL BEACH CA
91932-3527
US

IV. Provider business mailing address

1092 IMPERIAL BEACH BLVD APT A
IMPERIAL BEACH CA
91932-2873
US

V. Phone/Fax

Practice location:
  • Phone: 619-708-6354
  • Fax:
Mailing address:
  • Phone: 619-513-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: