Provider Demographics
NPI:1407172356
Name:ZAMBRANO, FREDDY (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDDY
Middle Name:
Last Name:ZAMBRANO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1666 MEDICAL CENTER DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92411-1257
Mailing Address - Country:US
Mailing Address - Phone:909-881-5007
Mailing Address - Fax:951-689-4800
Practice Address - Street 1:1666 MEDICAL CENTER DR STE 3
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1257
Practice Address - Country:US
Practice Address - Phone:909-881-5007
Practice Address - Fax:951-689-4800
Is Sole Proprietor?:No
Enumeration Date:2010-04-18
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist