Healthcare Provider Details

I. General information

NPI: 1316188857
Provider Name (Legal Business Name): HAIDEE DAVID ZAMORA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 OAK ST
EUGENE OR
97401-4043
US

IV. Provider business mailing address

1426 OAK STREET
EUGENE OR
97401-4043
US

V. Phone/Fax

Practice location:
  • Phone: 541-431-9501
  • Fax:
Mailing address:
  • Phone: 541-431-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLP00804
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD153867
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD153867
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: