Healthcare Provider Details

I. General information

NPI: 1043139082
Provider Name (Legal Business Name): MILTON C ZAMORA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 S ORCHARD AVE
UKIAH CA
95482-5022
US

IV. Provider business mailing address

399 CABERNET PL # B
UKIAH CA
95482-3351
US

V. Phone/Fax

Practice location:
  • Phone: 707-472-0350
  • Fax:
Mailing address:
  • Phone: 714-548-0053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number756742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: