Healthcare Provider Details

I. General information

NPI: 1578365136
Provider Name (Legal Business Name): CAMARENA HEALTH NETWORK IPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39765 DATE ST STE 102
MURRIETA CA
92563-2005
US

IV. Provider business mailing address

39765 DATE ST STE 102
MURRIETA CA
92563-2005
US

V. Phone/Fax

Practice location:
  • Phone: 951-894-4665
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DAVID KIMBER
Title or Position: CHIEF BUSINESS DEVELOPMENT OFFICER
Credential:
Phone: 858-344-7887