Individual provider · NPI-1

Mark Escudero

Radiology, Pediatric Radiology · Roseville, CA

NPI number1235373549
StatusActive
Last updated in NPPESDec 15, 2021

Details

NPI
1235373549
Entity type
Individual (NPI-1)
Name
Mark Escudero
Sex
Male
Sole proprietor
No
Enumeration date
Apr 30, 2009
Last updated
Dec 15, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085P0229X Radiology, Pediatric RadiologyA129633CAYes

Practice location

1600 Eureka Rd
Dept Of Radiology
Roseville, CA 95661-3027

Phone 858-337-6226

Mailing address

938 Old Ranch House Rd
Rocklin, CA 95765-6285

Phone 858-337-6226

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