Organization Name: | OAKLAND MED GROUP CORP. |
NPI Number: | 1386979540 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDGAR N ESCOBAR (DOCTOR) |
Mailing Address: | 7800 W Oakland Park Blvd Suite B-104 Sunrise |
State: | FL US |
Postal Code: | 333516741 |
Phone Number: | 9546260352 |
Fax Number: | 9546260354 |
NPI Enumeration Date: | 10/06/2009 |
NPI Last Update Date: | 01/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME65056 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |