Healthcare Provider Details

I. General information

NPI: 1306420286
Provider Name (Legal Business Name): EVA GUADALUPE ESCOBEDO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 W WILLOW AVE STE 502
VISALIA CA
93291-6268
US

IV. Provider business mailing address

78 E BAY STATE ST UNIT 1C
ALHAMBRA CA
91801-6819
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-4820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH82809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: