| Doctor Name: | DR. ENRIQUE CAMACHO |
| NPI Number: | 1235570037 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 20A12825 |
| Business Practice Address: | 15301 Warren Shingle Rd Beale Afb, CA - 959031907 |
| Business Phone Number: | 5306344730 |
| Business Fax Number: | |
| Mailing Address: | 15301 Warren Shingle Rd, BEALE AFB |
| State: | CA |
| Postal Code: | 959031907 |
| Phone Number: | 5306344730 |
| Fax Number: | |
| NPI Enumeration Date: | 07/10/2013 |
| NPI Last Update Date: | 07/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A12825 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |