Provider Demographics
NPI:1255493763
Name:JOSE U. ZAMORA, II, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JOSE U. ZAMORA, II, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:858-637-4800
Mailing Address - Street 1:7125 N CHESTNUT AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0358
Mailing Address - Country:US
Mailing Address - Phone:559-765-4868
Mailing Address - Fax:559-797-4674
Practice Address - Street 1:7125 N CHESTNUT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0358
Practice Address - Country:US
Practice Address - Phone:559-765-4868
Practice Address - Fax:559-797-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51141208600000X
CA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17014Medicare ID - Type Unspecified
CAF51970Medicare UPIN