Provider Demographics
NPI:1952395402
Name:ESTEBAN, JOSE M (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:ESTEBAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2219 WEST OLIVE AVE #219
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2625
Mailing Address - Country:US
Mailing Address - Phone:818-847-6052
Mailing Address - Fax:818-847-6029
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-847-6052
Practice Address - Fax:818-847-6029
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2017-07-14
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Provider Licenses
StateLicense IDTaxonomies
CAA43207207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A432070Medicaid
CA00A432070Medicaid
CAE92276Medicare UPIN