Provider Demographics
NPI:1215107750
Name:ROMEO F ESQUIVEL MD PLLC
Entity type:Organization
Organization Name:ROMEO F ESQUIVEL MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:F
Authorized Official - Last Name:ESQUIVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-722-3777
Mailing Address - Street 1:PO BOX 43130
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3130
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:6130 N LA CHOLLA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3557
Practice Address - Country:US
Practice Address - Phone:520-575-5003
Practice Address - Fax:520-297-3146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29123207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ318126Medicaid
H66091Medicare UPIN
AZ318126Medicaid