Individual provider Active NPI

Daniel Camarillo Jr., MD

  • Family Medicine Physician
  • Menifee, CA
National Provider Identifier
1073693552
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A89728 Issued in CA
Practice address
30420 Haun Rd
Menifee, CA 92584-6810
Phone
(951) 676-4193
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A89728 CA Primary

Addresses

Primary practice location

30420 Haun Rd
Menifee, CA 92584-6810

Mailing address

28780 Single Oak Dr
160
Temecula, CA 92590-3625
Phone (951) 676-4193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000526 CA Practitioner - Family Practice 1456353374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

30420 Haun Rd
Menifee, CA 92584-6810
Phone (951) 676-4193

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
98728CAMDMarriage & Family Therapist
A89728CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rancho Family Medical Group, Inc. Family Medicine CurrentSince Nov 1, 2011 Accepting new patients
Santa Lucia Medical Group, Inc. Family Medicine Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Locations

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

3853 W Stetson Ave
Ste 200
Hemet, CA 92545
Phone (951) 225-6802

30420 Haun Rd
Menifee, CA 92584

28780 Single Oak Dr
Ste 160
Temecula, CA 92590
Phone (951) 658-9461

31720 US Highway 79
Ste 100
Temecula, CA 92592
Phone (909) 303-6300

Interoperability endpoints

  • Direct secure messaging: dcamarillo181854@direct.llu.edu
  • Direct secure messaging: dcamarillo25836@direct.svmh.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1073693552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28780 SINGLE OAK DR",
            "address_2": "160",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925903625",
            "telephone_number": "951-676-4193",
            "fax_number": "951-719-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30420 HAUN RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925846810",
            "telephone_number": "951-676-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARILLO",
        "first_name": "DANIEL",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A89728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

Verify at the official NPI Registry.