Provider Demographics
NPI:1124213236
Name:ZARENO CORPORATION
Entity Type:Organization
Organization Name:ZARENO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-335-0204
Mailing Address - Street 1:405 E ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-3502
Mailing Address - Country:US
Mailing Address - Phone:626-335-0204
Mailing Address - Fax:626-355-0306
Practice Address - Street 1:405 E ROUTE 66
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3502
Practice Address - Country:US
Practice Address - Phone:626-335-0204
Practice Address - Fax:626-355-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU7018FMedicaid