MEDICARE: CLAUDIO G ZAMORANO M.D.

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	207RC0000X	Cardiovascular Disease Physician	10019	AZ
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	10019	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	62-1867509	OTHER	AZ	TAX IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1841488426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIO G ZAMORANO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 61773
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85082-1773
Country	:	US
Telephone Number	:	602-266-2200
Fax Number	:	602-240-6177

Provider Business Practice Location Address
First Line	:	708 COEUR D'ALENE
Second Line	:	SUITE B
City	:	PAYSON
State	:	AZ
Zip	:	85541-5662
Country	:	US
Telephone Number	:	928-474-2175
Fax Number	:	928-474-9424

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	11/28/2012

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