Healthcare Provider Details

I. General information

NPI: 1730258195
Provider Name (Legal Business Name): SUHAIL HANNA ZAVARO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S PIERCE ST #102
EL CAJON CA
92020-4124
US

IV. Provider business mailing address

300 S PIERCE ST #102
EL CAJON CA
92020-4124
US

V. Phone/Fax

Practice location:
  • Phone: 619-668-4700
  • Fax: 619-668-0049
Mailing address:
  • Phone: 619-668-4700
  • Fax: 619-668-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA46162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: