Provider Demographics
NPI:1861874943
Name:ESCOBAR, JOSE DAVID (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:DAVID
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 STARFALL LN
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2369
Mailing Address - Country:US
Mailing Address - Phone:480-313-7152
Mailing Address - Fax:
Practice Address - Street 1:2084 STARFALL LN
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-2369
Practice Address - Country:US
Practice Address - Phone:480-313-7152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422982251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics