Active NPI
Camilo Q. Primero, M.D.
- Anesthesiology Physician
- Glendora, CA
National Provider Identifier
1295804029
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 19, 2019.
- Section 1128b(4) exclusion effective Jun 20, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A31170
- Practice address
- 150 W Route 66
Glendora, CA 91740-6207 - Phone
- (626) 335-0231
- Fax
- (626) 335-5082
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A31170 | CA | Primary |
Addresses
Primary practice location
150 W Route 66
Glendora, CA 91740-6207
Mailing address
500 S Main St
1210
Orange, CA 92868-4507
Phone (714) 560-1580
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A31170 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Health Care, Inc. | Past | Accepting new patients | |
| Angel Eye Hospice, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community Based Hospice Care Agency
- Las Vegas, NV
- NPI 1649398835
-
- Home Health Agency
- Las Vegas, NV
- NPI 1659465847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1295804029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S MAIN ST",
"address_2": "1210",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684507",
"telephone_number": "714-560-1580",
"fax_number": "714-560-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 W ROUTE 66",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917406207",
"telephone_number": "626-335-0231",
"fax_number": "626-335-5082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIMERO",
"first_name": "CAMILO",
"middle_name": "Q.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A31170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.