Healthcare Provider Details

I. General information

NPI: 1881937191
Provider Name (Legal Business Name): ALEX CARCAMO MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 MIDDLEFIELD RD STE 1
PALO ALTO CA
94301-2920
US

IV. Provider business mailing address

590 FARRINGTON HWY # 524-204
KAPOLEI HI
96707-2009
US

V. Phone/Fax

Practice location:
  • Phone: 650-933-3421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA SMITH
Title or Position: GENERAL MANAGER
Credential:
Phone: 650-933-3421