Healthcare Provider Details

I. General information

NPI: 1083354765
Provider Name (Legal Business Name): ABDEL MEJIA ZAVALA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 08/19/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE UNIT 20
ALHAMBRA CA
91803-8840
US

IV. Provider business mailing address

237 N CENTRAL AVE STE A
GLENDALE CA
91203-3526
US

V. Phone/Fax

Practice location:
  • Phone: 626-602-9454
  • Fax:
Mailing address:
  • Phone: 661-360-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: