Healthcare Provider Details

I. General information

NPI: 1740395318
Provider Name (Legal Business Name): HIMAYA BORJA ZUNIGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4161 W KLING ST APT 16
BURBANK CA
91505-3318
US

IV. Provider business mailing address

2351 SONGBIRD LN
ROWLAND HEIGHTS CA
91748-3962
US

V. Phone/Fax

Practice location:
  • Phone: 818-843-5225
  • Fax:
Mailing address:
  • Phone: 626-839-7066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP 15297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: