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General NPI Number Information
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NPI Number | 1578365136
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Entity Type | Organization
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Legal Business Name | CAMARENA HEALTH NETWORK IPA
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 39765 DATE ST STE 102
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City | MURRIETA
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State | CA
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Zip | 92563-2005
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Country | US
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Telephone | 951-894-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 39765 DATE ST STE 102
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City | MURRIETA
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State | CA
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Zip | 92563-2005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF BUSINESS DEVELOPMENT OFFICER
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Name | DAVID KIMBER
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Credential |
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Telephone | 858-344-7887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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