Provider Demographics
NPI:1679532808
Name:CAMARO, JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:CAMARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2378 STAR AVE
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-6348
Mailing Address - Country:US
Mailing Address - Phone:510-866-7151
Mailing Address - Fax:
Practice Address - Street 1:1250 45TH ST
Practice Address - Street 2:STE 355
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2959
Practice Address - Country:US
Practice Address - Phone:510-596-8988
Practice Address - Fax:510-596-8956
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA877764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A877640Medicaid
I25250Medicare UPIN
CA00A877640Medicaid