Provider Demographics
NPI:1821027699
Name:ZAMORA, LILIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LILIA
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 VIA CAMPO
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-1807
Mailing Address - Country:US
Mailing Address - Phone:323-720-1144
Mailing Address - Fax:323-720-5596
Practice Address - Street 1:2603 VIA CAMPO
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-1807
Practice Address - Country:US
Practice Address - Phone:323-720-1144
Practice Address - Fax:323-720-5596
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG068059207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0040672Medicaid
CAGR0040672Medicaid
CAE98039Medicare UPIN