Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | A71492 | CA |
N | 208200000X | Surgeon | A71492 | CA |
N | 208600000X | Surgeon | A71492 | CA |
NPI | 1942225388 |
---|---|
Provider Name | Alfonso Camberos |
First Address | San Diego, CA 92123-4209 |
Second Address | San Diego, CA 92123-4209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 16/02/2016 |