Individual
MR. ZOZIMO R MALANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12234 CLYDESDALE DR, RANCHO CUCAMONGA, CA 91739-9041
(909) 899-0157
(909) 463-9242
Mailing address
12234 CLYDESDALE DR, RANCHO CUCAMONGA, CA 91739-9041
(909) 899-0157
(909) 463-9242
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTN01121F
—
CA
Enumeration date
10/23/2006
Last updated
07/08/2007
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