Healthcare Provider Details

I. General information

NPI: 1700357787
Provider Name (Legal Business Name): MARIA ESCANDOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EL CAMINO REAL
SOUTH SAN FRANCISCO CA
94080-3208
US

IV. Provider business mailing address

330 WHEELER AVE
SAN FRANCISCO CA
94134-2446
US

V. Phone/Fax

Practice location:
  • Phone: 650-742-2324
  • Fax:
Mailing address:
  • Phone: 415-272-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number22916
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: