Provider Demographics
NPI:1043626781
Name:ESPEJO, HECTOR MANUEL (RT)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:MANUEL
Last Name:ESPEJO
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 224
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93447
Mailing Address - Country:US
Mailing Address - Phone:801-427-8167
Mailing Address - Fax:
Practice Address - Street 1:2178 JOHNSON
Practice Address - Street 2:
Practice Address - City:SLO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:801-427-8167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor