Healthcare Provider Details

I. General information

NPI: 1073240362
Provider Name (Legal Business Name): CARLOS AUGUSTO ESCOBAR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 09/28/2025
Certification Date: 09/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 CHURN CREEK RD UNIT 492142
REDDING CA
96049-5329
US

IV. Provider business mailing address

2323 CHURN CREEK RD UNIT 492142
REDDING CA
96049-5329
US

V. Phone/Fax

Practice location:
  • Phone: 424-205-4293
  • Fax:
Mailing address:
  • Phone: 530-224-1437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number86371
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: