Basic Information
| Provider Information | |||||||||
| NPI: | 1710376793 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ESGUERRA | ||||||||
| FirstName: | RODRIGO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 245 E WILSHIRE AVE | ||||||||
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| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928321935 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 245 E WILSHIRE AVE | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928321935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148716020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2015 | ||||||||
| LastUpdateDate: | 01/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 8837 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.