Individual
FERNANDO ANTONIO ZAMUDIO
Inactive
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6655 ALVARADO RD, SAN DIEGO, CA 92120-5208
(619) 583-0511
(619) 582-2012
Mailing address
PO BOX 22211, SAN DIEGO, CA 92192-2211
(619) 583-0511
(619) 582-2012
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
C26245
CA
207RI0011X
Interventional Cardiology Physician
C26245
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C262450
BLUE SHIELD
CA
05
—
00C262450
—
CA
01
—
756061700
RR MEDICARE
CA
Enumeration date
06/27/2005
Last updated
03/21/2011
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