MEDICARE: ZAMORA DIXON

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1740546480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAMORA DIXON

Provider Business Mailing Address
First Line	:	4701 E SAHARA AVE
Second Line	:	APT. 230
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-6300
Country	:	US
Telephone Number	:	323-539-8516
Fax Number	:

Provider Business Practice Location Address
First Line	:	580 W CHEYENNE AVE
Second Line	:	STE 70
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-3967
Country	:	US
Telephone Number	:	702-648-3913
Fax Number	:

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

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	04/06/2012

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Directions to “ ZAMORA DIXON ” Practice Location

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