Healthcare Provider Details

I. General information

NPI: 1659193506
Provider Name (Legal Business Name): EMILY ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S OLIVE ST STE 1200
LOS ANGELES CA
90015-2211
US

IV. Provider business mailing address

1101 NOLDEN ST
LOS ANGELES CA
90042-1953
US

V. Phone/Fax

Practice location:
  • Phone: 213-783-0093
  • Fax:
Mailing address:
  • Phone: 323-204-6517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: