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General NPI Number Information
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NPI Number | 1346774411
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Entity Type | Organization
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Legal Business Name | ZAPPATERRA, INC
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 1035 S FAIR OAKS AVE SUITE 103
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City | PASADENA
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State | CA
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Zip | 91105-2699
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Country | US
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Telephone | 626-269-9277
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 FREMONT AVE # 1514
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-3224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MAURO ZAPPATERRA
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Credential | MD/PHD
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Telephone | 626-269-9277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A118673
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License Number State | CA
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