Individual provider Active NPI

Marianne E. Camous, P.A

  • Physician Assistant
  • Burlingame, CA
National Provider Identifier
1326155268
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14358 Issued in CA
Practice address
1663 Rollins Rd
Burlingame, CA 94010-2301
Phone
(650) 692-2663
Fax
(650) 692-2777
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14358 CA Primary

Addresses

Primary practice location

1663 Rollins Rd
Burlingame, CA 94010-2301

Mailing address

129 Dolton Ave
San Carlos, CA 94070-1629
Phone (650) 704-0601

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA14358CAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: marianna.camous.p47@direct.medcor.nextgenshare.com
  • Direct secure messaging: marianne.camous.p32@direct.medcor.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1326155268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 DOLTON AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940701629",
            "telephone_number": "650-704-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 ROLLINS RD",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940102301",
            "telephone_number": "650-692-2663",
            "fax_number": "650-692-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMOUS",
        "first_name": "MARIANNE",
        "middle_name": "E.",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.