Healthcare Provider Details

I. General information

NPI: 1447284179
Provider Name (Legal Business Name): DAVID ROBERT ESQUIBEL OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2367 E TAHQUITZ CANYON WAY
PALM SPRINGS CA
92262
US

IV. Provider business mailing address

2367 E TAHQUITZ CANYON WAY
PALM SPRINGS CA
92262
US

V. Phone/Fax

Practice location:
  • Phone: 760-327-8528
  • Fax: 760-327-7577
Mailing address:
  • Phone: 760-327-8528
  • Fax: 760-327-7577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7792T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: