Provider Demographics
NPI:1194301531
Name:ESTRADA, ADAM (CPT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 N OXNARD BLVD STE 24
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-3503
Mailing Address - Country:US
Mailing Address - Phone:805-603-3161
Mailing Address - Fax:805-307-7736
Practice Address - Street 1:1825 N OXNARD BLVD STE 24
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3503
Practice Address - Country:US
Practice Address - Phone:805-603-3161
Practice Address - Fax:805-307-7736
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00047057246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy