Healthcare Provider Details

I. General information

NPI: 1215290937
Provider Name (Legal Business Name): DAVID ESCORCIA OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 06/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10844 ROSE AVE APT 9
LOS ANGELES CA
90034-5316
US

IV. Provider business mailing address

10844 ROSE AVE APT 9
LOS ANGELES CA
90034-5316
US

V. Phone/Fax

Practice location:
  • Phone: 626-497-8234
  • Fax: 310-841-5123
Mailing address:
  • Phone: 626-497-8234
  • Fax: 310-841-5123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: