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1225554231 NPI number — ALEXANDER RAYMOND CAMBA

NPI Number: 1225554231
Health Care Provider/Practitioner: ALEXANDER RAYMOND CAMBA

Information about “1225554231” NPI (ALEXANDER RAYMOND CAMBA) exists in 1225554231 in HTML format HTML  |  1225554231 in plain Text format TXT  |  1225554231 in PDF (Portable Document Format) PDF  |  1225554231 in an XML format XML  formats.

NPI Number : 1225554231 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225554231",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CAMBA",
    "FirstName": "ALEXANDER",
    "MiddleName": "RAYMOND",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CAMBA",
    "OtherFirstName": "RAYMOND",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "OTR/L",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "429 SANTA ROSA RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ARCADIA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91007-3042",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2131 W 3RD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90057-1901",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "213-484-7111",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/21/2017",
    "LastUpdateDate": "08/21/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "OT16445",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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