Provider Demographics
NPI:1295837177
Name:ESQUIVEL-AGUILAR, GRACIELA (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACIELA
Middle Name:
Last Name:ESQUIVEL-AGUILAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3748 E SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-7028
Mailing Address - Country:US
Mailing Address - Phone:559-224-7272
Mailing Address - Fax:559-224-7290
Practice Address - Street 1:3748 E SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-7028
Practice Address - Country:US
Practice Address - Phone:559-224-7272
Practice Address - Fax:559-224-7290
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35880208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A358800Medicare ID - Type Unspecified
CAA88355Medicare UPIN