Provider Demographics
NPI:1851357917
Name:OBA, CAMERON ISAO (MD)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:ISAO
Last Name:OBA
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 1:2410 SAMARITAN DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-3909
Mailing Address - Country:US
Mailing Address - Phone:408-371-9010
Mailing Address - Fax:408-371-2633
Practice Address - Street 1:2410 SAMARITAN DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3909
Practice Address - Country:US
Practice Address - Phone:408-371-9010
Practice Address - Fax:408-371-2633
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA68975207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A689750OtherRAILROAD MEDICARE
CA00A689750Medicare PIN
CAH25217Medicare UPIN
CA00A689750Medicare ID - Type Unspecified