Provider Demographics
NPI:1578096038
Name:ESCALANTE, LEONARDO PITER JR
Entity Type:Individual
Prefix:MR
First Name:LEONARDO
Middle Name:PITER
Last Name:ESCALANTE
Suffix:JR
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 1:251 W MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-2202
Mailing Address - Country:US
Mailing Address - Phone:760-351-9466
Mailing Address - Fax:760-351-9477
Practice Address - Street 1:251 W MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2202
Practice Address - Country:US
Practice Address - Phone:760-351-9460
Practice Address - Fax:760-351-9477
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment