Healthcare Provider Details

I. General information

NPI: 1861752016
Provider Name (Legal Business Name): LAILANIE ONG ZARATE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23018 MISSION DR
CARSON CA
90745-4953
US

IV. Provider business mailing address

23018 MISSION DRIVE
CARSON CA
90745
US

V. Phone/Fax

Practice location:
  • Phone: 310-974-2794
  • Fax: 310-549-6383
Mailing address:
  • Phone: 310-974-2794
  • Fax: 310-549-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: