MEDICARE: MAY CHARLENE QUIRINO ZAMORA

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	363LF0000X	Family Nurse Practitioner	95009217	CA

General Provider Information

NPI Number	:	1831683234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAY CHARLENE QUIRINO ZAMORA

Provider Business Mailing Address
First Line	:	77 QUIET HILLS RD
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91766-4764
Country	:	US
Telephone Number	:	909-509-0389
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 N MOUNTAIN AVE STE 128
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-1132
Country	:	US
Telephone Number	:	909-949-9299
Fax Number	:	909-949-9029

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

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	06/19/2018

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