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Organization
MARIO CARCAMO MD INC
Active
Organization
MARIO CARCAMO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO P CARCAMO M.D. (CEO)
(951) 684-8020
Entity
Organization
Contact information
Practice address
4440 BROCKTON AVE STE 420, RIVERSIDE, CA 92501-4026
(951) 684-8020
(951) 684-8090
Mailing address
4440 BROCKTON AVE STE 420, RIVERSIDE, CA 92501-4026
(951) 684-8020
(951) 684-8090
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A35551
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0102440
—
CA
Enumeration date
12/06/2007
Last updated
12/06/2007
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