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NPI Code Detail

MEDICARE: ADELAIDA A ZAVALA RN

MEDICARE: ADELAIDA A ZAVALA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse95189053CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
195189053OTHERWORK RELATED INJURIES

General Provider Information

NPI Number : 1235702804
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELAIDA A ZAVALA RN
Provider Business Mailing Address
First Line : 3200 INLAND EMPIRE BLVD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5569
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 INLAND EMPIRE BLVD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5569
Country : US
Telephone Number : 909-202-0001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2021
Last Update Date : 07/21/2021

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Directions to “ ADELAIDA A ZAVALA RN” Practice Location

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