Provider Demographics
NPI:1184628927
Name:ZAMBRANO, OSCAR GUILLERMO (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:GUILLERMO
Last Name:ZAMBRANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-2521
Mailing Address - Country:US
Mailing Address - Phone:323-581-1649
Mailing Address - Fax:323-581-3472
Practice Address - Street 1:6513 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-2521
Practice Address - Country:US
Practice Address - Phone:323-581-1649
Practice Address - Fax:323-581-3472
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29529207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A295290Medicaid
CA00A295290Medicaid
CAA29529Medicare ID - Type UnspecifiedMEDICARE PROV #
CAA83973Medicare UPIN