MEDICARE: HIMAYA BORJA ZUNIGA

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	363L00000X	Nurse Practitioner	NP 15297	CA

General Provider Information

NPI Number	:	1740395318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIMAYA BORJA ZUNIGA

Provider Business Mailing Address
First Line	:	2351 SONGBIRD LN
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-3962
Country	:	US
Telephone Number	:	626-839-7066
Fax Number	:

Provider Business Practice Location Address
First Line	:	4161 W KLING ST APT 16
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-3318
Country	:	US
Telephone Number	:	818-843-5225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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