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General NPI Number Information
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NPI Number | 1912777418
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Entity Type | Individual
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Provider Name | ALEXANDER ESCOBAR PA
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Gender | Male
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Dates
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Enumeration Date | 01/05/2024
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 4000 CIVIC CENTER DR STE 209
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City | SAN RAFAEL
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State | CA
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Zip | 94903-5233
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Country | US
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Telephone | 415-925-8963
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 CIVIC CENTER DR STE 209
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City | SAN RAFAEL
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State | CA
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Zip | 94903-5233
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Country | US
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Telephone | 559-443-2682
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Fax | 559-443-2681
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 64166
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License Number State | CA
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