John R Campbell, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G031914 Issued in CA

Practice address

901 E St
Ste 285
San Rafael, CA 94901-2850

Phone

(415) 454-5565

Fax

(415) 454-2957

NPI assigned

May 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1619970928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E ST",
            "address_2": "STE 285",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012850",
            "telephone_number": "415-454-5565",
            "fax_number": "415-454-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E ST",
            "address_2": "STE 285",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012850",
            "telephone_number": "415-454-5565",
            "fax_number": "415-454-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G031914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0015750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Daniel Camacho, MS, PPS
• Lisa Camarda, DPT
• Frances Cameron
• Morgan Clark Camp, MD
• Kate Elizabeth Campagna, BS
• Muriel Jamaine Campbell, MS, CNS
• Patricia A Campbell, LCSW
• Toni Campbell, DC
• Torri Anne Campbell, PH.D.
• Laurie Elizabeth Campion, CNC

• Specialist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.