Provider Demographics
NPI:1679759609
Name:TOMAS, JUL-TRENTON CAMACHO (RT)
Entity Type:Individual
Prefix:MR
First Name:JUL-TRENTON
Middle Name:CAMACHO
Last Name:TOMAS
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23543 UNDERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4828
Mailing Address - Country:US
Mailing Address - Phone:951-852-7192
Mailing Address - Fax:
Practice Address - Street 1:23543 UNDERWOOD CIR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4828
Practice Address - Country:US
Practice Address - Phone:951-852-7192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARRT: 278129247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist