Provider Demographics
NPI:1336672450
Name:ESPINOZA, EDWARD EMILIANO II
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:EMILIANO
Last Name:ESPINOZA
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BOLLINGER CANYON WAY STE A15
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5297
Mailing Address - Country:US
Mailing Address - Phone:925-735-8508
Mailing Address - Fax:
Practice Address - Street 1:500 BOLLINGER CANYON WAY STE A15
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-5297
Practice Address - Country:US
Practice Address - Phone:925-735-8508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC33842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor