Doctor Name: | JOHN CAMESA |
NPI Number: | 1073683736 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.AC. |
License Number: | AC9257 |
Business Practice Address: | 8205 Santa Monica Blvd Ste 12b West Hollywood, CA - 900465963 |
Business Phone Number: | 3236565115 |
Business Fax Number: | |
Mailing Address: | Po Box 2276, ANAHEIM |
State: | CA |
Postal Code: | 928140276 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/09/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | AC9257 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |