Healthcare Provider Details

I. General information

NPI: 1023496338
Provider Name (Legal Business Name): ZUMAYA HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 S ORANGE AVE
WEST COVINA CA
91790-2662
US

IV. Provider business mailing address

PO BOX 5004
GLENDORA CA
91740-0019
US

V. Phone/Fax

Practice location:
  • Phone: 626-338-8481
  • Fax: 626-960-9178
Mailing address:
  • Phone: 626-338-8481
  • Fax: 626-960-9178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MS. VICKI P ROLLINS
Title or Position: VICE-PRESIDENT
Credential: RN
Phone: 562-426-6141