Individual provider Active NPI

John Camesa, L.AC.

  • General Practice Physician
  • West Hollywood, CA
National Provider Identifier
1073683736
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
AC9257 Issued in CA
Practice address
8205 Santa Monica Blvd Ste 12B
West Hollywood, CA 90046-5963
Phone
(323) 656-5115
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X AC9257 CA Primary

Addresses

Primary practice location

8205 Santa Monica Blvd Ste 12B
West Hollywood, CA 90046-5963

Mailing address

PO Box 2276
Anaheim, CA 92814-0276

Other identifiers 1

IdentifierTypeStateIssuer
AC0092570MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC9257CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073683736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2276",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928140276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8205 SANTA MONICA BLVD STE 12B",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465963",
            "telephone_number": "323-656-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMESA",
        "first_name": "JOHN",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "AC9257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC0092570",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.