Basic Information
| Provider Information | |||||||||
| NPI: | 1275613424 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMACHO | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | APRN-RX, ACNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | HOSPITALIST PROGRAM | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086917657 | ||||||||
| FaxNumber: | 8086915033 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 PUNCHBOWL ST | ||||||||
| Address2: | HOSPITALIST PROGRAM | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086917657 | ||||||||
| FaxNumber: | 8086915033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 09/23/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | SPOO8067 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 163WE0003X | RN-73940 | HI | N | Nursing Service Providers | Registered Nurse | Emergency | 163WC0200X | RN-73940 | HI | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LA2100X | APRN-1571 | HI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LC0200X | APRN-1571 | HI | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Critical Care Medicine | 363L00000X | APRN-1571 | HI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.