Healthcare Provider Details

I. General information

NPI: 1609157940
Provider Name (Legal Business Name): MR. DANIEL ZATARAIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 INLAND EMPIRE BLVD
ONTARIO CA
91764-4898
US

IV. Provider business mailing address

4610 SANTA ANITA AVE
EL MONTE CA
91731-1311
US

V. Phone/Fax

Practice location:
  • Phone: 909-458-1375
  • Fax: 909-944-1059
Mailing address:
  • Phone: 626-453-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: