Healthcare Provider Details

I. General information

NPI: 1477524197
Provider Name (Legal Business Name): TONY ESCALONA VASQUEZ M.D.,PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 S OREGON ST
YREKA CA
96097-3425
US

IV. Provider business mailing address

1950 COURT ST
REDDING CA
96001-1823
US

V. Phone/Fax

Practice location:
  • Phone: 530-530-1980
  • Fax:
Mailing address:
  • Phone: 530-225-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG52980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: