Healthcare Provider Details

I. General information

NPI: 1508415274
Provider Name (Legal Business Name): CAMARENA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 COUNTRY CLUB DR
MADERA CA
93638-1537
US

IV. Provider business mailing address

PO BOX 299
MADERA CA
93639-0299
US

V. Phone/Fax

Practice location:
  • Phone: 559-664-4000
  • Fax:
Mailing address:
  • Phone: 559-664-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUZVINDA GABRIELA MARTINEZ
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 559-664-4000