Healthcare Provider Details

I. General information

NPI: 1255493763
Provider Name (Legal Business Name): JOSE U. ZAMORA, II, M.D., A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 N CHESTNUT AVE SUITE 103
FRESNO CA
93720-0358
US

IV. Provider business mailing address

7125 N CHESTNUT AVE SUITE 103
FRESNO CA
93720-0358
US

V. Phone/Fax

Practice location:
  • Phone: 559-765-4868
  • Fax: 559-797-4674
Mailing address:
  • Phone: 559-765-4868
  • Fax: 559-797-4674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA51141
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. JOSE ZAMORA II
Title or Position: PRESIDENT, CORPORATION
Credential: MD
Phone: 858-637-4800