Healthcare Provider Details

I. General information

NPI: 1417909631
Provider Name (Legal Business Name): CAMINO MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N MATHILDA AVE
SUNNYVALE CA
94085-4207
US

IV. Provider business mailing address

301 OLD SAN FRANCISCO RD
SUNNYVALE CA
94086-6386
US

V. Phone/Fax

Practice location:
  • Phone: 408-739-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SLAVIN
Title or Position: CEO
Credential:
Phone: 408-739-6000