Provider Demographics
NPI:1750869574
Name:ESCOBAR, JOHN ANTHONY JR (RRT, SDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:ESCOBAR
Suffix:JR
Gender:M
Credentials:RRT, SDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14712 NOVA SCOTIA DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-0618
Mailing Address - Country:US
Mailing Address - Phone:909-587-7657
Mailing Address - Fax:
Practice Address - Street 1:9961 SIERRA AVE # MOB7
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33652227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered