Provider Demographics
NPI:1841488426
Name:ZAMORANO, CLAUDIO G (MD)
Entity type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:G
Last Name:ZAMORANO
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:PO BOX 61773
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-1773
Mailing Address - Country:US
Mailing Address - Phone:602-266-2200
Mailing Address - Fax:602-240-6177
Practice Address - Street 1:708 COEUR D'ALENE
Practice Address - Street 2:SUITE B
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5662
Practice Address - Country:US
Practice Address - Phone:928-474-2175
Practice Address - Fax:928-474-9424
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10019207RC0000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ300379Medicaid
AZ62-1867509OtherTAX IDENTIFICATION NUMBER
AZ300379Medicaid