Provider Demographics
NPI:1154501898
Name:JOHN W ZAMARRA MD INC
Entity Type:Organization
Organization Name:JOHN W ZAMARRA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ZAMARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-871-5200
Mailing Address - Street 1:1001 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3811
Mailing Address - Country:US
Mailing Address - Phone:714-871-5200
Mailing Address - Fax:714-871-2877
Practice Address - Street 1:1001 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3811
Practice Address - Country:US
Practice Address - Phone:714-871-5200
Practice Address - Fax:714-871-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37204207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW21871Medicare PIN