Provider Demographics
NPI:1518052489
Name:ZAMARRA, JOHN W (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:ZAMARRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1001 E CHAPMAN AVE
Mailing Address - Street 2:B
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:B
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG37204207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G372040Medicaid
CAG37204Medicare PIN
CAWG37204CMedicare PIN