Healthcare Provider Details

I. General information

NPI: 1669500559
Provider Name (Legal Business Name): RICHARD ANTHONY ESQUIVEL OMD, L.AC., DNBAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 01/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1649 S MAIN ST STE. 102
MILPITAS CA
95035-6287
US

IV. Provider business mailing address

1649 S MAIN ST STE. 102
MILPITAS CA
95035-6287
US

V. Phone/Fax

Practice location:
  • Phone: 408-262-6606
  • Fax: 408-262-6616
Mailing address:
  • Phone: 408-262-6606
  • Fax: 408-262-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: