Healthcare Provider Details

I. General information

NPI: 1043874001
Provider Name (Legal Business Name): JOSE FELIX ESPARZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOSE FELIX ESPARZA-GUZMAN

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 S SUNWEST LN STE 200
SAN BERNARDINO CA
92408-3248
US

IV. Provider business mailing address

1950 S SUNWEST LN STE 200
SAN BERNARDINO CA
92408-3248
US

V. Phone/Fax

Practice location:
  • Phone: 909-252-4010
  • Fax: 909-252-4055
Mailing address:
  • Phone: 909-252-4010
  • Fax: 909-252-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: