1942448923 NPI number — MR. ALBERT QUIRAP ESCOBAR PHYSICAL THERAPIST

Table of content: MR. ALBERT QUIRAP ESCOBAR PHYSICAL THERAPIST (NPI 1942448923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942448923 NPI number — MR. ALBERT QUIRAP ESCOBAR PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESCOBAR
Provider First Name:
ALBERT
Provider Middle Name:
QUIRAP
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942448923
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1538 W DELVALE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST COVINA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91790-4545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-717-0450
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
433 N 4TH ST
Provider Second Line Business Practice Location Address:
STE 216
Provider Business Practice Location Address City Name:
MONTEBELLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90640-4309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-530-0433
Provider Business Practice Location Address Fax Number:
323-530-0434
Provider Enumeration Date:
01/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT19096 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 19096 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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