Healthcare Provider Details
I. General information
NPI: 1326368176
Provider Name (Legal Business Name): STEPHEN MICHAEL ESKAROS, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2010
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3751 KATELLA AVE
LOS ALAMITOS CA
90720-3113
US
IV. Provider business mailing address
PO BOX 60790
PASADENA CA
91116-6790
US
V. Phone/Fax
- Phone: 562-598-1311
- Fax: 562-799-3133
- Phone: 626-204-6747
- Fax: 626-396-0851
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | A104081 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
STEPHEN
MICHAEL
ESKAROS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-925-0940