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General NPI Number Information
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NPI Number | 1487523601
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Entity Type | Individual
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Provider Name | JOSEF ZILDJIAN ESCOBAR DEJOS OTA
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Gender | Male
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 6537 MOHICAN DR
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City | BUENA PARK
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State | CA
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Zip | 90620-1617
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Country | US
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Telephone | 707-502-7261
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Fax |
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Provider Business Mailing Address
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Address Line | 6537 MOHICAN DR
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City | BUENA PARK
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State | CA
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Zip | 90620-1617
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Country | US
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Telephone | 707-502-7261
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2176
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License Number State | CA
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