Provider Demographics
NPI:1477524197
Name:VASQUEZ, TONY ESCALONA (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:ESCALONA
Last Name:VASQUEZ
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 COURT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1823
Mailing Address - Country:US
Mailing Address - Phone:530-225-8008
Mailing Address - Fax:
Practice Address - Street 1:1950 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1823
Practice Address - Country:US
Practice Address - Phone:530-225-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52980174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist