Healthcare Provider Details

I. General information

NPI: 1295485993
Provider Name (Legal Business Name): EMILIO ESQUIVEL MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W MACARTHUR BLVD
OAKLAND CA
94611-5641
US

IV. Provider business mailing address

275 W MACARTHUR BLVD
OAKLAND CA
94611-5641
US

V. Phone/Fax

Practice location:
  • Phone: 408-728-1756
  • Fax:
Mailing address:
  • Phone: 510-752-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number190811
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA190811
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: