Basic Information
| Provider Information | |||||||||
| NPI: | 1265886196 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMERO AMORTEGUI | ||||||||
| FirstName: | FELIPE | ||||||||
| MiddleName: | ORLANDO | ||||||||
| NamePrefix: | |||||||||
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| Credential: | D.O | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | CAMERO | ||||||||
| OtherFirstName: | FELIPE | ||||||||
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| OtherCredential: | D.O | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3400 DATA DR | ||||||||
| Address2: | ATTN CREDENTIALING/PAYER ENROLLMENT | ||||||||
| City: | RANCHO CORDOVA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956707956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 17051 SIERRA LAKES PKWY STE 101 | ||||||||
| Address2: | |||||||||
| City: | FONTANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923361274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098644700 | ||||||||
| FaxNumber: | 9094282191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2016 | ||||||||
| LastUpdateDate: | 08/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 20A17433 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.