Healthcare Provider Details

I. General information

NPI: 1003780750
Provider Name (Legal Business Name): ALVARO ZUNIGA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W LODI AVE
LODI CA
95240-3582
US

IV. Provider business mailing address

15500 EAGLE LN
LATHROP CA
95330-9306
US

V. Phone/Fax

Practice location:
  • Phone: 209-369-0186
  • Fax:
Mailing address:
  • Phone: 209-814-2042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: