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General NPI Number Information
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NPI Number | 1932737186
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Entity Type | Individual
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Provider Name | AMELINDA MARTHA ZAVARO-KHANJIAN DO
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Gender | Female
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 5525 GROSSMONT CENTER DR
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City | LA MESA
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State | CA
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Zip | 91942-3009
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Country | US
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Telephone | 602-246-5525
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Fax |
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Provider Business Mailing Address
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Address Line | 1994 VIA CASA ALTA
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City | LA JOLLA
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State | CA
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Zip | 92037-5730
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Country | US
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Telephone | 619-857-4255
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A21499
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License Number State | CA
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