Healthcare Provider Details

I. General information

NPI: 1740318690
Provider Name (Legal Business Name): RUBEN JEREMIAS ZALAPA OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WILSHIRE BLVD STE 500
LOS ANGELES CA
90017-1934
US

IV. Provider business mailing address

7316 WHITSETT AVE
LOS ANGELES CA
90001-2233
US

V. Phone/Fax

Practice location:
  • Phone: 213-482-9400
  • Fax:
Mailing address:
  • Phone: 323-587-8461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number14001
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: