Provider Demographics
NPI:1023503810
Name:ESQUIBEL, ARIEL (OD)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:ESQUIBEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 HARROD WAY
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-5339
Mailing Address - Country:US
Mailing Address - Phone:928-727-3220
Mailing Address - Fax:
Practice Address - Street 1:383 LAKE HAVASU AVE S
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-9368
Practice Address - Country:US
Practice Address - Phone:928-680-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT34381-TLG152W00000X
AZOPT-002324152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist