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General NPI Number Information
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NPI Number | 1407172356
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Entity Type | Individual
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Provider Name | FREDDY ZAMBRANO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2010
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 1666 MEDICAL CENTER DR STE 3
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1257
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Country | US
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Telephone | 909-881-5007
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Fax | 951-689-4800
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Provider Business Mailing Address
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Address Line | 1666 MEDICAL CENTER DR STE 3
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City | SAN BERNARDINO
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State | CA
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Zip | 92411-1257
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Country | US
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Telephone | 909-881-5007
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Fax | 951-689-4800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 59080
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License Number State | CA
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