Provider Demographics
NPI:1477722791
Name:ESCURRA, HEIDI LILIANA (MD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:LILIANA
Last Name:ESCURRA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:242 E HARVARD BLVD
Practice Address - Street 2:STE C
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-3372
Practice Address - Country:US
Practice Address - Phone:805-525-9595
Practice Address - Fax:805-525-6667
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2021-12-01
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Provider Licenses
StateLicense IDTaxonomies
CAA102739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA102739OtherMEDICAL LICENSE