MEDICARE: CAITLYN CAMARGO PA-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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1871310409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN CAMARGO PA-C

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	714-443-4512
Fax Number	:

Provider Business Practice Location Address
First Line	:	12488 CENTRAL AVE STE B
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2625
Country	:	US
Telephone Number	:	909-613-0100
Fax Number	:

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

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	03/09/2026

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Directions to “ CAITLYN CAMARGO PA-C” Practice Location

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