Individual
MARLENE P. ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6043 HOLLYWOOD BLVD, LOS ANGELES, CA 90028-5411
(323) 217-7047
Mailing address
PO BOX 19043, LOS ANGELES, CA 90019-0943
(323) 217-7047
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
20174
CA
363AS0400X
Surgical Physician Assistant
20174
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA20174
—
CA
Enumeration date
01/29/2009
Last updated
10/10/2016
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