Individual
CARLOS ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT36298
Contact information
Practice address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0026
(909) 463-3977
Mailing address
303 E VANDERBILT WAY, SAN BERNARDINO, CA 92415-0026
(909) 463-3977
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
—
—
Other
Enumeration date
09/27/2016
Last updated
10/06/2016
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