Provider Demographics
NPI:1568499549
Name:CAMBRE, ATHLEO LOUIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ATHLEO
Middle Name:LOUIS
Last Name:CAMBRE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:STE 214
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3703
Mailing Address - Country:US
Mailing Address - Phone:310-777-6677
Mailing Address - Fax:310-777-6680
Practice Address - Street 1:9201 W SUNSET BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3701
Practice Address - Country:US
Practice Address - Phone:310-777-6677
Practice Address - Fax:310-777-6680
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-06-13
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Provider Licenses
StateLicense IDTaxonomies
CAG60551208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG60551OtherSTATE LICENSE NUMBER
CAG60551OtherSTATE LICENSE NUMBER