Healthcare Provider Details

I. General information

NPI: 1154409274
Provider Name (Legal Business Name): LIZBETH ESCOBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8019 S. COMPTON AVE.
LOS ANGELES CA
90280-4654
US

IV. Provider business mailing address

8019 S. COMPTON AVE.
LOS ANGELES CA
90280-4654
US

V. Phone/Fax

Practice location:
  • Phone: 323-586-7333
  • Fax: 323-419-1979
Mailing address:
  • Phone: 323-586-7333
  • Fax: 323-419-1979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: