MEDICARE: DR. DIEGO ANGEL CAMACHO D.C.

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	111N00000X	Chiropractor	8077	AZ

General Provider Information

NPI Number	:	1386979920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIEGO ANGEL CAMACHO D.C.

Provider Business Mailing Address
First Line	:	426 W PRESIDENT ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85714-1368
Country	:	US
Telephone Number	:	520-889-4347
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-4506
Country	:	US
Telephone Number	:	520-305-9656
Fax Number	:

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

Provider Enumeration Date	:	10/15/2009
Last Update Date	:	07/27/2016

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