Healthcare Provider Details

I. General information

NPI: 1023999448
Provider Name (Legal Business Name): AIDA MARIN ZAMORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 S BASCOM AVE
SAN JOSE CA
95128-2699
US

IV. Provider business mailing address

5408 MAKATI CIR
SAN JOSE CA
95123-6251
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number95114423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: