MEDICARE: CAMARENA HEALTH

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1770141350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMARENA HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 299
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93639-0299
Country	:	US
Telephone Number	:	559-664-4000
Fax Number	:	559-675-5625

Provider Business Practice Location Address
First Line	:	2339 W CLEVELAND AVE STE 103
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-8765
Country	:	US
Telephone Number	:	559-664-4000
Fax Number	:

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	LUZVINDA GABRIELA MARTINEZ
Credential	:
Telephone Number	:	559-664-4000

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	05/30/2019

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Directions to “CAMARENA HEALTH ” Practice Location

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