Provider Demographics
NPI:1568217800
Name:CAMACHO, GEORGE MUNOZ SR
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:MUNOZ
Last Name:CAMACHO
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5316
Mailing Address - Country:US
Mailing Address - Phone:661-203-2561
Mailing Address - Fax:
Practice Address - Street 1:404 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5316
Practice Address - Country:US
Practice Address - Phone:661-203-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver