Healthcare Provider Details

I. General information

NPI: 1073455937
Provider Name (Legal Business Name): ZAMIR CARBALLO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 S COLLEGE AVE STE B
FORT COLLINS CO
80525-5404
US

IV. Provider business mailing address

2111 S COLLEGE AVE STE B
FORT COLLINS CO
80525-5404
US

V. Phone/Fax

Practice location:
  • Phone: 714-812-6044
  • Fax:
Mailing address:
  • Phone: 970-232-9159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0009073
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: