Provider Demographics
NPI:1427090505
Name:ZAMORANO, DAVID P (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
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 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83647-1026
Mailing Address - Country:US
Mailing Address - Phone:208-367-3330
Mailing Address - Fax:208-367-3331
Practice Address - Street 1:1075 N CURTIS ROAD
Practice Address - Street 2:STE 300
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706
Practice Address - Country:US
Practice Address - Phone:208-367-3330
Practice Address - Fax:208-367-3331
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73913207X00000X
IDM-13182207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI09245Medicare UPIN
CAWA73913CMedicare PIN
CAA73913OtherSTATE LICENSE NUMBER