Active NPI
Omar Camacho
- Health & Wellness Coach
- Glendale, CA
National Provider Identifier
1679317879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- Practice address
- 330 N Brand Blvd Ste 700
Glendale, CA 91203-2336 - Phone
- (608) 673-3357
- NPI assigned
- Jun 21, 2024
- 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 |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | Primary |
Addresses
Primary practice location
330 N Brand Blvd Ste 700
Glendale, CA 91203-2336
Mailing address
1315 Prospect Ave Apt 208
San Gabriel, CA 91776-4451
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1679317879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 PROSPECT AVE APT 208",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "917764451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 N BRAND BLVD STE 700",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912032336",
"telephone_number": "608-673-3357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "OMAR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.