Healthcare Provider Details

I. General information

NPI: 1700184413
Provider Name (Legal Business Name): MARIA ZAVALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 E GRAND AVE
ESCONDIDO CA
92025-4605
US

IV. Provider business mailing address

543 N CEDAR ST
ESCONDIDO CA
92025-3123
US

V. Phone/Fax

Practice location:
  • Phone: 760-741-2660
  • Fax:
Mailing address:
  • Phone: 760-807-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: