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NPI Code Detail

MEDICARE: LOUIS ESCANDON MD

MEDICARE: LOUIS ESCANDON MD
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
1208D00000XGeneral Practice PhysicianG34397CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992853709
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUIS ESCANDON MD
Provider Business Mailing Address
First Line : 5425 POMONA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-1716
Country : US
Telephone Number : 323-728-0411
Fax Number : 323-728-1535
Provider Business Practice Location Address
First Line : 5425 POMONA BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-1716
Country : US
Telephone Number : 323-728-0411
Fax Number : 323-728-1535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 05/25/2012

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Directions to “ LOUIS ESCANDON MD” Practice Location

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