Provider Demographics
NPI:1639221872
Name:DOWNS, PAMELA CAMPBELL (PT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:CAMPBELL
Last Name:DOWNS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:LYNN
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 S HARBOR BLVD # 150
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7909
Mailing Address - Country:US
Mailing Address - Phone:714-428-3520
Mailing Address - Fax:714-748-7622
Practice Address - Street 1:3601 S HARBOR BLVD # 150
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7909
Practice Address - Country:US
Practice Address - Phone:714-428-3520
Practice Address - Fax:714-748-7622
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33328204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT33328OtherLICENSE #