Healthcare Provider Details

I. General information

NPI: 1790756070
Provider Name (Legal Business Name): ASHRAF I ESKANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 N WATERMAN AVE
SAN BERNARDINO CA
92404-4836
US

IV. Provider business mailing address

700 E REDLANDS BLVD #U345
REDLANDS CA
92373-6152
US

V. Phone/Fax

Practice location:
  • Phone: 909-883-8711
  • Fax:
Mailing address:
  • Phone: 909-435-6162
  • Fax: 909-792-9417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA48837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: