Active NPI
Albert Camacho
- Pharmacist
- Fort Irwin, CA
National Provider Identifier
1770828451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH-1350
- Practice address
- 170 Inner Loop CR
Room 207- Mary Walker Clinic
Fort Irwin, CA 92310-5109 - Phone
- (760) 380-3130
- NPI assigned
- Dec 6, 2012
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH-1350 | HI | Primary |
Addresses
Primary practice location
170 Inner Loop CR
Room 207- Mary Walker Clinic
Fort Irwin, CA 92310-5109
Mailing address
550 Yucca Ave
Apt J120
Barstow, CA 92311-3223
Phone (808) 497-1776
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH-1350 | HI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1770828451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 YUCCA AVE",
"address_2": "APT J120",
"city": "BARSTOW",
"state": "CA",
"postal_code": "923113223",
"telephone_number": "808-497-1776",
"fax_number": "760-380-1922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 INNER LOOP CR",
"address_2": "ROOM 207- MARY WALKER CLINIC",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "923105109",
"telephone_number": "760-380-3130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "ALBERT",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-06",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH-1350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.