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General NPI Number Information
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NPI Number | 1285512848
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Entity Type | Individual
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Provider Name | MARC-RYAN ESCALONA
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Gender | Male
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 910 HALE PL
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City | CHULA VISTA
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State | CA
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Zip | 91914-3504
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Country | US
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Telephone | 619-948-8075
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Fax |
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Provider Business Mailing Address
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Address Line | 1176 SPARROW LAKE RD
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City | CHULA VISTA
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State | CA
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Zip | 91913-2890
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Country | US
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Telephone | 619-948-8075
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Fax | 619-948-8075
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 51812
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License Number State | CA
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