Healthcare Provider Details

I. General information

NPI: 1558738369
Provider Name (Legal Business Name): KARINA ZAPATA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 RUGBY AVE
HUNTINGTON PARK CA
90255-4066
US

IV. Provider business mailing address

1243 W 120TH ST
LOS ANGELES CA
90044-1123
US

V. Phone/Fax

Practice location:
  • Phone: 323-277-7678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95022567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: