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General NPI Number Information
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NPI Number | 1811052343
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Entity Type | Individual
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Provider Name | NORMAN ROY ZALAMEDA UNTALAN DDS
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 730 S WESTERN AVE STE 202
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City | LOS ANGELES
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State | CA
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Zip | 90005-5901
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Country | US
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Telephone | 213-385-3828
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Fax | 213-385-2144
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Provider Business Mailing Address
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Address Line | 5009 ALTA CANYADA RD
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City | LA CANADA
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State | CA
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Zip | 91011-1716
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Country | US
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Telephone | 818-952-2630
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Fax | 213-385-2144
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49693
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License Number State | CA
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