MEDICARE: ZAMBRANO & ALVARADO DDS INC

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1447593330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZAMBRANO & ALVARADO DDS INC

Provider Business Mailing Address
First Line	:	1666 MEDICAL CENTER DR STE 3
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92411-1257
Country	:	US
Telephone Number	:	909-881-5007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1666 MEDICAL CENTER DR STE 3
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92411-1257
Country	:	US
Telephone Number	:	909-881-5007
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. FREDDY ZAMBRANO
Credential	:	D.D.S.
Telephone Number	:	818-660-8196

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	08/16/2021

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