MARIO CARCAMO MD INC (NPI# 1821271412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821271412 |
| Entity Type | Organization |
| Organization Name | MARIO CARCAMO MD INC |
| Practice Address |
4440 Brockton Ave Ste 420 Riverside CA 92501-4026 |
| Practice Telephone | 9516848020 |
| Practice Fax Number | 9516848090 |
| Mailing Telephone | 9516848020 |
| Mailing Fax Number | 9516848090 |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2007-12-06 |
| Authorized Official Name | MARIO P CARCAMO (CEO) |
| Authorized Official Telephone | 9516848020 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A35551 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0102440 | 05 |
| Street Address |
4440 BROCKTON AVE STE 420 |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92501-4026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312392 | Elizabeth Coleman | Nurse Practitioner | 4440 Brockton Ave Ste 420, Riverside, CA 92501-4026 | 2017-08-16 |
| 1518340751 | Jeanette Faderan Baldonado | Registered Nurse | 4440 Brockton Ave Ste 420, Riverside, CA 92501-4026 | 2015-07-07 |
| 1780066480 | Naga Ramya Chowdary | Pediatrics | 4440 Brockton Ave Ste 420, Riverside, CA 92501-4026 | 2015-06-18 |
| 1851680078 | Kimberly Joy Buck | Nurse Practitioner | 4440 Brockton Ave Ste 420, Riverside, CA 92501-4026 | 2011-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700437605 | Mary Horvatin | Technician | 1811 Rivera Strret, Riverside, CA 92501 | 2019-09-23 |
| 1366905473 | Timothy Daniel Collins | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme, Office, Riverside, CA 92501 | 2019-04-08 |
| 1346709672 | Lourdes Adame | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Ave - Gme Office, Riverside, CA 92501 | 2019-03-16 |
| 1740759067 | Kristina Ferris-celosse | Counselor | 2452 Wilshire St., Riverside, CA 92501 | 2018-11-15 |
| 1750888095 | Arunmozhi Aravagiri | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, Gme Office, 4445 Magnolia Ave., Riverside, CA 92501 | 2018-04-12 |
| 1720585847 | Alan Huynh | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue., Gme Office, Riverside, CA 92501 | 2018-04-06 |
| 1538664834 | Wilson Paul Frasca | Student in an Organized Health Care Education/Training Program | 4445 Magnolia Avenue, Riverside, CA 92501 | 2018-03-28 |
| 1851896575 | Geethu Gopinathan Nair | Student in an Organized Health Care Education/Training Program | Riverside Community Hospital, 4445 Magnolia Ave., Gme Office, Riverside, CA 92501 | 2018-03-26 |
| 1316465560 | Thilini Anne Abeygunaratne | Marriage & Family Therapist | 1950 Market Street, Riverside, CA 92501 | 2017-09-07 |
| 1194257410 | Melissa Chitwood | Assistant Behavior Analyst | 3078 Cedar St., Riverside, CA 92501 | 2017-03-28 |
| Find all providers in zip 92501 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1093264145 | Nephrology Associates Medical Group, Inc. | Specialist | 3660 Park Sierra Dr Ste 203, Riverside, CA 92505-3071 | 2016-09-30 |
| 1639625247 | Dana Keim | Specialist | 6864 Indiana Ave Ste 104a, Riverside, CA 92506 | 2016-09-01 |
| 1720401615 | Matthew Martinez | Specialist | 8205 Coleman St, Riverside, CA 92504-3107 | 2014-01-28 |
| 1649512575 | Michael C Luciano | Specialist | 3120 Chicago Ave, Suite #170, Riverside, CA 92507-3490 | 2013-03-18 |
| 1508110461 | Luis Angel Calvillo Jr. | Specialist | 246 Plews Ct, Riverside, CA 92507-1100 | 2012-10-30 |
| 1639474513 | Jeanne Dunkel | Specialist | 3529 Hoover St, Riverside, CA 92504-3907 | 2011-01-24 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.