MEDICARE: DR. JOSE LUIS CAMPOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A90846	CA

General Provider Information

NPI Number	:	1245288034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE LUIS CAMPOS MD

Provider Business Mailing Address
First Line	:	2185 N LINWOOD ST
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-8603
Country	:	US
Telephone Number	:	559-791-7047
Fax Number	:	559-781-8193

Provider Business Practice Location Address
First Line	:	101 NORTH PALM STREET
Second Line	:
City	:	WOODLAKE
State	:	CA
Zip	:	93286-1422
Country	:	US
Telephone Number	:	559-564-0100
Fax Number	:	559-564-2285

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	11/19/2010

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Directions to “ DR. JOSE LUIS CAMPOS MD” Practice Location

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