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General NPI Number Information
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NPI Number | 1417286725
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Entity Type | Organization
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Legal Business Name | FERNANDO A ZAMUDIO MD INC
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 6655 ALVARADO RD
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City | SAN DIEGO
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State | CA
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Zip | 92120-5208
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Country | US
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Telephone | 760-230-1353
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Fax | 760-230-6283
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Provider Business Mailing Address
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Address Line | PO BOX 22211
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City | SAN DIEGO
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State | CA
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Zip | 92192-2211
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Country | US
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Telephone | 760-230-1353
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Fax | 760-230-6283
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO ANTONIO ZAMUDIO
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Credential | MD
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Telephone | 619-583-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | C26245
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License Number State | CA
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