Healthcare Provider Details
I. General information
NPI: 1427531391
Provider Name (Legal Business Name): DAVID ZUNIGA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/07/2018
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13651 WILLARD ST
PANORAMA CITY CA
91402
US
IV. Provider business mailing address
16839 MERION LN
FONTANA CA
92336-5151
US
V. Phone/Fax
- Phone: 818-375-2000
- Fax:
- Phone: 760-265-2713
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2279P3900X |
| Taxonomy | Neonatal/Pediatric Registered Respiratory Therapist |
| License Number | 145638 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: