Provider Demographics
NPI:1811221443
Name:CAMARADOR, ARLENE (PT)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:CAMARADOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S CATALINA AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5515
Mailing Address - Country:US
Mailing Address - Phone:310-378-7246
Mailing Address - Fax:310-373-9618
Practice Address - Street 1:1919 S CATALINA AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5515
Practice Address - Country:US
Practice Address - Phone:310-378-7246
Practice Address - Fax:310-373-9618
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29124PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI25774Medicare UPIN
CAW14413Medicare PIN