Healthcare Provider Details

I. General information

NPI: 1548729833
Provider Name (Legal Business Name): ESON PIUS EKPO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9898 GENESEE AMP 400
LA JOLLA CA
92037
US

IV. Provider business mailing address

870 QUARRY RD CVRC FALK
STANFORD CA
94305-5406
US

V. Phone/Fax

Practice location:
  • Phone: 858-824-4134
  • Fax: 858-964-3114
Mailing address:
  • Phone: 650-725-4177
  • Fax: 650-725-1599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA176995
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA176995
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberW4092
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberA176995
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: