Healthcare Provider Details

I. General information

NPI: 1780716415
Provider Name (Legal Business Name): ZAVARO CARDIOVASCULAR INSTITUTE, AMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 04/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SOUTH PIERCE STREET SUITE #102
EL CAJON CA
92020-4124
US

IV. Provider business mailing address

300 S PIERCE ST SUITE #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: SUHAIL H ZAVARO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 619-668-4700