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NPI Code Detail

MEDICARE: JONATHAN ESCOBAR

MEDICARE:   JONATHAN  ESCOBAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1437669546
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ESCOBAR
Provider Business Mailing Address
First Line : 10897 COLOMA RD UNIT 2
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95670-2635
Country : US
Telephone Number : 415-623-9690
Fax Number :
Provider Business Practice Location Address
First Line : 8801 FOLSOM BLVD STE 195
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-3231
Country : US
Telephone Number : 510-268-8120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2017
Last Update Date : 10/03/2017

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Directions to “ JONATHAN ESCOBAR ” Practice Location

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