Provider Demographics
NPI:1649979444
Name:ESPARZA, EDGARDO
Entity type:Individual
Prefix:
First Name:EDGARDO
Middle Name:
Last Name:ESPARZA
Suffix:
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 1:1360 MISSION ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2647
Mailing Address - Country:US
Mailing Address - Phone:628-217-7710
Mailing Address - Fax:628-217-7705
Practice Address - Street 1:1360 MISSION ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2647
Practice Address - Country:US
Practice Address - Phone:628-217-7710
Practice Address - Fax:628-217-7705
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator