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General NPI Number Information
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NPI Number | 1093608101
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Entity Type | Organization
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Legal Business Name | ESVYDA HEALTH
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 155 E CAMPBELL AVE STE 107
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City | CAMPBELL
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State | CA
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Zip | 95008-2049
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Country | US
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Telephone | 408-660-8666
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Fax | 408-508-5576
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Provider Business Mailing Address
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Address Line | 293 ESTHER AVE
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City | CAMPBELL
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State | CA
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Zip | 95008-1202
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Country | US
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Telephone | 408-829-0985
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Fax | 408-508-5576
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Authorized Official
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Title or Position | CEO
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Name | ELIAS LOZANO
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Credential |
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Telephone | 408-829-0985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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