MEDICARE: RUDY ESAU MARCHORRO JR CPT

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
1	246RP1900X	Phlebotomy Technician		CA

General Provider Information

NPI Number	:	1730029117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUDY ESAU MARCHORRO JR CPT

Provider Business Mailing Address
First Line	:	10921 OTIS ST
Second Line	:
City	:	LYNWOOD
State	:	CA
Zip	:	90262-2150
Country	:	US
Telephone Number	:	310-926-1235
Fax Number	:

Provider Business Practice Location Address
First Line	:	17434 BELLFLOWER BLVD STE 200-243
Second Line	:
City	:	BELLFLOWER
State	:	CA
Zip	:	90706-6849
Country	:	US
Telephone Number	:	310-926-1235
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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