Provider Demographics
NPI:1164144945
Name:KARLA CAMACHO
Entity Type:Organization
Organization Name:KARLA CAMACHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL CLAIMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-209-8924
Mailing Address - Street 1:2013 DAIRY MART RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-1848
Mailing Address - Country:US
Mailing Address - Phone:619-209-8924
Mailing Address - Fax:
Practice Address - Street 1:AV MADERO 834
Practice Address - Street 2:STE 4
Practice Address - City:MEXICALI
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:21100
Practice Address - Country:MX
Practice Address - Phone:619-209-8924
Practice Address - Fax:916-625-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty