Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | G24054 | CA |
NPI | 1164484697 |
---|---|
Provider Name | K Cameron Campbell |
First Address | Van Nuys, CA 91410-0076 |
Second Address | Chula Vista, CA 91911-6617 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 26/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G240540 | (05) | CA |