Provider Demographics
NPI:1720309537
Name:ALFONSO CAMBEROS, MD
Entity Type:Organization
Organization Name:ALFONSO CAMBEROS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMBEROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:858-740-7263
Mailing Address - Street 1:1311 CHERRY TREE CIR
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6909
Mailing Address - Country:US
Mailing Address - Phone:714-470-4354
Mailing Address - Fax:866-352-4510
Practice Address - Street 1:1463 S 4TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4749
Practice Address - Country:US
Practice Address - Phone:760-351-8669
Practice Address - Fax:866-352-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA714922082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA264233779OtherIRS - EMPLOYER IDENTIFICATION NUMBER