Healthcare Provider Details

I. General information

NPI: 1720752280
Provider Name (Legal Business Name): RICARDO ALEXIS ZUNIGA FLORES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 W OLYMPIC BLVD
LOS ANGELES CA
90015-3808
US

IV. Provider business mailing address

11233 BORDEN AVE APT 5
PACOIMA CA
91331-1506
US

V. Phone/Fax

Practice location:
  • Phone: 323-433-4165
  • Fax:
Mailing address:
  • Phone: 818-405-2631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: