Healthcare Provider Details

I. General information

NPI: 1902527518
Provider Name (Legal Business Name): ANDRES CAMILO ESCOBAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 W OXFORD AVE UNIT G-3
DENVER CO
80236-3115
US

IV. Provider business mailing address

3525 W OXFORD AVE UNIT G-3
DENVER CO
80236-3115
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-0287
  • Fax:
Mailing address:
  • Phone: 303-315-0287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number09933887
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: