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General NPI Number Information
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NPI Number | 1578096038
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Entity Type | Individual
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Provider Name | MR. LEONARDO PITER ESCALANTE JR.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 251 W MAIN ST STE F
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City | BRAWLEY
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State | CA
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Zip | 92227-2202
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Country | US
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Telephone | 760-351-9460
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Fax | 760-351-9477
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Provider Business Mailing Address
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Address Line | 251 W MAIN ST STE F
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City | BRAWLEY
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State | CA
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Zip | 92227-2202
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Country | US
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Telephone | 760-351-9466
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Fax | 760-351-9477
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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