Gerald Joseph Camarata, MD
Individual provider Active NPI Family Medicine Physician · Sonoma, CA
NPI 1013969815 · NPPES record last updated Jan 30, 2012
Key facts
- NPI
- 1013969815
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G69724 (CA)
- Practice address
- 15000 Arnold Drive
Sonoma, CA 95431-1493 - Phone
- (707) 938-6556
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060131000749 | CA | Practitioner - Family Practice | 6204840051 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69724 | CA | MD | Pharmacist |
| G69724 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of California - Department of Developmental Services | Current | Accepting new patients | |
| State of California - Department of Developmental Services | Current |
Accepting new patients | |
| Agnews Community Clinic | Current |
Accepting new patients | |
| State of California - Department of Developmental Services | Past | Accepting new patients | |
| State of California - Department of Developmental Services | Past | Accepting new patients |
Locations
15000 Arnold Dr
Eldridge, CA 95431
Phone (707) 938-6000
3530 Pomona Blvd
Pomona, CA 91768
Phone (909) 444-7200
26501 Avenue 140
Porterville, CA 93257
Phone (559) 782-2222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G69724 | CA | Yes |
Addresses
Primary practice location
15000 Arnold Drive
Sonoma, CA 95431-1493
Mailing address
1600 9TH Street
Room 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431
Other providers in Sonoma, CA
- Phyllis Burt
- Janet Kay Byrd
- Katy Ann Byrne
- Caliente Springs Physical Therapy Inc
- California Avant-Garde Physicians
- Campbell & Verducci
- Campbell & Verducci
- S Douglas Campbell
- Julie Marie Carlson
- James A Carr
All providers in Sonoma, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.