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Individual

IVON CAMPO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M

Contact information

Practice address
3055 W ORANGE AVE, SUITE 202, ANAHEIM, CA 92804-3159
(714) 527-1262
Mailing address
3055 W ORANGE AVE, SUITE 202, ANAHEIM, CA 92804-3159
(714) 527-1262

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C43138
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A348130
CA
Enumeration date
10/17/2005
Last updated
01/24/2013
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