Healthcare Provider Details

I. General information

NPI: 1417872383
Provider Name (Legal Business Name): ELMER ADOLFO ZARATE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

6633 1/2 KESTER AVE
VAN NUYS CA
91405-4521
US

V. Phone/Fax

Practice location:
  • Phone: 213-938-1575
  • Fax:
Mailing address:
  • Phone: 818-809-9143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: