Individual provider Active NPI

Christopher Peter Camilleri, M.D.

  • Psychiatry Physician
  • Cerritos, CA
National Provider Identifier
1154419836
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A72671 Issued in CA
Practice address
17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone
(562) 402-0688
Fax
(562) 402-3032
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A72671 CA Primary

Addresses

Primary practice location

17707 Studebaker Rd
Cerritos, CA 90703-2640

Mailing address

17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone (562) 402-0688

Other identifiers 1

IdentifierTypeStateIssuer
WA72671BOtherCAMEDICARE PPIN

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
I20060328000714 CA Practitioner - Psychiatry 4587672878 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Nov 14, 2005 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Nov 14, 2005 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients

Locations

17707 Studebaker Rd
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

349A E Avenue K6
Lancaster, CA 93535
Phone (661) 723-4260

522 S San Pedro St
Los Angeles, CA 90013
Phone (213) 486-4085

1720 E 120th St
Los Angeles, CA 90059
Phone (310) 668-4272

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Interoperability endpoints

  • Direct secure messaging: bharath.raghukultilakmd.d1.p1@direct.jwch.nextgenshare.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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1154419836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688",
            "fax_number": "562-402-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688",
            "fax_number": "562-402-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILLERI",
        "first_name": "CHRISTOPHER",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A72671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PPIN",
            "identifier": "WA72671B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.