Provider Demographics
NPI:1346774411
Name:ZAPPATERRA, INC
Entity type:Organization
Organization Name:ZAPPATERRA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPPATERRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD/PHD
Authorized Official - Phone:626-269-9277
Mailing Address - Street 1:1001 FREMONT AVE # 1514
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-3224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2699
Practice Address - Country:US
Practice Address - Phone:626-269-9277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA118673208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty