Healthcare Provider Details

I. General information

NPI: 1427843176
Provider Name (Legal Business Name): OCTAVIO ESCAMILLA SANCHEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 ILLINOIS STREET 10TH FLOOR, BOX 0132
SAN FRANCISCO CA
94143-2510
US

IV. Provider business mailing address

490 ILLINOIS STREET 10TH FLOOR, BOX 0132
SAN FRANCISCO CA
94143-2510
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: