Provider Demographics
NPI:1447284179
Name:ESQUIBEL, DAVID ROBERT (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:ESQUIBEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2367 E TAHQUITZ CANYON WAY
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-327-8528
Mailing Address - Fax:760-327-7577
Practice Address - Street 1:2367 E TAHQUITZ CANYON WAY
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-327-8528
Practice Address - Fax:760-327-7577
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7792T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0750510001Medicare ID - Type Unspecified
T10599Medicare UPIN