Healthcare Provider Details

I. General information

NPI: 1265499826
Provider Name (Legal Business Name): DAVID W CAMACHO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 PONAHAWAI ST #103
HILO HI
96720
US

IV. Provider business mailing address

10800 E GEDDES AVE STE 300
ENGLEWOOD CO
80112-3895
US

V. Phone/Fax

Practice location:
  • Phone: 808-933-2540
  • Fax: 808-935-5207
Mailing address:
  • Phone: 303-761-9190
  • Fax: 720-874-4462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberMD9328
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDR.0055817
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD9328
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberMD9328
License Number StateHI
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD9328
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: