Provider Demographics
NPI:1265499826
Name:CAMACHO, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:CAMACHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:670 PONAHAWAI ST
Practice Address - Street 2:#103
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-933-2540
Practice Address - Fax:808-935-5207
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD93282085N0904X, 2085R0204X, 2085U0001X, 2085R0202X
CODR.00558172085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07727401Medicaid
G21604Medicare UPIN
HI01WCCBG14Medicare ID - Type Unspecified