Provider Demographics
NPI:1265446280
Name:CAMPOS, AURELIO (MD)
Entity Type:Individual
Prefix:DR
First Name:AURELIO
Middle Name:
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3443 VILLA LN STE 9
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6417
Mailing Address - Country:US
Mailing Address - Phone:707-253-1566
Mailing Address - Fax:707-253-2014
Practice Address - Street 1:3443 VILLA LN STE 9
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6417
Practice Address - Country:US
Practice Address - Phone:707-253-1566
Practice Address - Fax:707-253-2014
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A826600Medicaid
CA00A826600Medicaid
CAH80183Medicare UPIN