Provider Demographics
NPI:1104145721
Name:PIMENTEL, ZARAH
Entity type:Individual
Prefix:
First Name:ZARAH
Middle Name:
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 CUSHING RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-6173
Mailing Address - Country:US
Mailing Address - Phone:619-524-5204
Mailing Address - Fax:
Practice Address - Street 1:2051 CUSHING RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6173
Practice Address - Country:US
Practice Address - Phone:619-524-5204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor