Provider Demographics
NPI:1992167886
Name:ALFARO QUEZADA, JOSE ESTEBAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ESTEBAN
Last Name:ALFARO QUEZADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E RIVER PARK CIR STE 460
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1585
Mailing Address - Country:US
Mailing Address - Phone:559-261-4503
Mailing Address - Fax:
Practice Address - Street 1:205 E RIVER PARK CIR STE 460
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1585
Practice Address - Country:US
Practice Address - Phone:559-261-4503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA154966208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty