Manuel Diego Campa, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A128248 Issued in CA

Practice address

1403 Lomita Blvd
Suite 200
Harbor City, CA 90710-2076

Phone

(310) 534-7600

NPI assigned

Jul 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1255696100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD",
            "address_2": "SUITE 200",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102076",
            "telephone_number": "310-534-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 LOMITA BLVD",
            "address_2": "SUITE 200",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907102076",
            "telephone_number": "310-534-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPA",
        "first_name": "MANUEL",
        "middle_name": "DIEGO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A128248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nico Angelo Maog Cadiz, PHARM.D.
• Andrew Dacayo Calderon, PA-C
• Olivia Hostetter Callese, M.D.
• Andy Paul Calvario
• Eric Calvario, OT
• Jean R Campos, NP
• Esther L Canales, CNM
• Janice Ruth Pantua Cansino, CRNA
• Bin Cao, MD
• Maria E. Capaldo, MD

• Family Medicine Physician in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.