Healthcare Provider Details

I. General information

NPI: 1932324696
Provider Name (Legal Business Name): JUAN ALBERTO ESCOBAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 W TEMPLE ST STE 3695
LOS ANGELES CA
90026-7336
US

IV. Provider business mailing address

6991 LIVINGSTON DR
HUNTINGTON BEACH CA
92648-1555
US

V. Phone/Fax

Practice location:
  • Phone: 213-989-0700
  • Fax: 213-989-0703
Mailing address:
  • Phone: 714-848-9348
  • Fax: 562-494-0866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG58271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: