Individual
DR. CARMINE A CAMMAROSANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1321 COTTONWOOD ST # 202, WOODLAND, CA 95695
(530) 668-2600
(530) 668-9591
Mailing address
3400 DATA DR., ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G67865
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G678650
BLUE SHIELD
CA
05
—
00G678650
—
CA
01
—
180025616
RR MEDICARE
CA
Enumeration date
07/15/2006
Last updated
06/27/2018
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