Camino Renal Care LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

CAMINO RENAL CARE LLC

Practice address

4225 Executive SQ Ste 450
La Jolla, CA 92037-8411

Phone

(858) 810-8000

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Glenn Davis

Title

President

Phone

(949) 246-8581

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1871161885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 450",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920378411",
            "telephone_number": "858-810-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 EXECUTIVE SQ STE 450",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920378411",
            "telephone_number": "858-810-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMINO RENAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-246-8581"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ma.Cristina Calma, ANP
• Calminds
• Mariam Bonyadi Camacho, MD, PHD
• Rachel Camarena
• Jesse A Camen, O.D.
• Caitlin Marie Campbell, M.S.
• Jean Campbell, PH.D.
• Anthony M Canarelli, PSY.D
• Julia Candelaria, DACM, L.AC
• Nicholas Canelo, MD

• Medical Specialty Clinic/Center in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.