Provider Demographics
NPI:1902824667
Name:CAMPBELL, JOHN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9292 CHESAPEAKE DR
Mailing Address - Street 2:#100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1059
Mailing Address - Country:US
Mailing Address - Phone:858-576-9960
Mailing Address - Fax:858-576-6857
Practice Address - Street 1:9292 CHESAPEAKE DR
Practice Address - Street 2:#100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1059
Practice Address - Country:US
Practice Address - Phone:858-576-9960
Practice Address - Fax:858-576-6857
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2015-05-04
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Provider Licenses
StateLicense IDTaxonomies
CAG43165207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G431650Medicaid
CAWG43165CMedicare PIN