Healthcare Provider Details

I. General information

NPI: 1346557261
Provider Name (Legal Business Name): RAMON CAMARENA NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 09/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4065 COUNTY CIRCLE DR
RIVERSIDE CA
92503-3410
US

IV. Provider business mailing address

37983 PANORAMA CT
MURRIETA CA
92562-5001
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-5077
  • Fax: 951-358-7098
Mailing address:
  • Phone: 951-894-4577
  • Fax: 951-894-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: