Provider Demographics
NPI:1316521503
Name:AESCALAPIUS MEDICI, INC.
Entity type:Organization
Organization Name:AESCALAPIUS MEDICI, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:442-217-7967
Mailing Address - Street 1:115 N EL CAMINO REAL STE A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1844
Mailing Address - Country:US
Mailing Address - Phone:442-217-7967
Mailing Address - Fax:
Practice Address - Street 1:115 N EL CAMINO REAL STE A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1844
Practice Address - Country:US
Practice Address - Phone:442-217-7967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty