Provider Demographics
NPI:1124020706
Name:ESCARCEGA, ARNOLD VICTOR (PA-C)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:VICTOR
Last Name:ESCARCEGA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 E HERNDON AVE
Mailing Address - Street 2:SUITE 431
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3309
Mailing Address - Country:US
Mailing Address - Phone:559-450-3889
Mailing Address - Fax:559-450-7473
Practice Address - Street 1:1105 E SPRUCE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3313
Practice Address - Country:US
Practice Address - Phone:559-450-7200
Practice Address - Fax:559-450-7214
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17096363A00000X
CA14495363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0214821OtherSTATE OF WASHINGTON
CAQ75073Medicare UPIN
CA0PA170960Medicare ID - Type Unspecified