Basic Information
| Provider Information | |||||||||
| NPI: | 1467860734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAMORA | ||||||||
| FirstName: | GEORGE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 S IMPERIAL AVE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | EL CENTRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922434242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603392802 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1503 N IMPERIAL AVE | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | EL CENTRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922436301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603392802 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2014 | ||||||||
| LastUpdateDate: | 12/17/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 95001047 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.