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General NPI Number Information
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NPI Number | 1679898308
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Entity Type | Individual
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Provider Name | OVET ESPARZA PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 200 JOSE FIGUERES AVE STE 490
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City | SAN JOSE
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State | CA
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Zip | 95116-1595
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Country | US
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Telephone | 408-272-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 1470 LAUREL ST APT 1
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City | SAN CARLOS
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State | CA
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Zip | 94070-5120
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Country | US
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Telephone | 928-271-9508
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 20860
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License Number State | CA
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