Healthcare Provider Details

I. General information

NPI: 1447772553
Provider Name (Legal Business Name): SARA CAMARENA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2017
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 W WHITTIER BLVD
MONTEBELLO CA
90640-3040
US

IV. Provider business mailing address

4425 S CENTRAL AVE
LOS ANGELES CA
90011-3629
US

V. Phone/Fax

Practice location:
  • Phone: 323-908-4200
  • Fax: 323-432-4877
Mailing address:
  • Phone: 323-908-4200
  • Fax: 323-432-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number54667
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: