Camelback West Medical Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

261Q00000X Issued in AZ

Legal business name

CAMELBACK WEST MEDICAL CLINIC

Practice address

5630 W Camelback Rd
Suite105
Glendale, AZ 85301-7443

Phone

(623) 337-3318

Fax

(623) 872-9704

NPI assigned

Aug 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Ruth Ethel Sanders, NP

Title

Npmmllc

Phone

(623) 337-3318

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033128293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 W CAMELBACK RD",
            "address_2": "SUITE105",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017443",
            "telephone_number": "623-337-3318",
            "fax_number": "623-872-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 W CAMELBACK RD",
            "address_2": "SUITE105",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017443",
            "telephone_number": "623-337-3318",
            "fax_number": "623-872-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELBACK WEST MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "ETHEL",
        "authorized_official_title_or_position": "NPMMLLC",
        "authorized_official_telephone_number": "623-337-3318",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "261Q00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvary Home Services Inc
• Tami Calvin
• Christena Elena Camacho, RN
• Edward Christian Miano Camacho, PMHNP-BC
• Zachery Tyler Camacho
• Alexandra Nicole Cammarata, MOT, OTR/L
• James Earnest Campbell, M.D.
• Julia Campbell
• Nicole Anne Campbell, M.D.
• Shannon Diane Campbell

• Clinic/Center in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.