Camacho, Samuel Albert

Camacho, Samuel Albert is an individual health care provider with primary practice located at 10201 Se Main St Suite 10, Portland OR 97216-2937. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Camacho, Samuel Albert can be contacted via phone (503) 257-0959.

Contact Information

Primary practice address
10201 Se Main St Suite 10 Portland OR 97216-2937
Phone: (503) 257-0959
Fax: (503) 257-3457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD21405 Oregon

Profile Details

NPI number 1598757452
LBN Legal business name Camacho, Samuel Albert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Oct 8th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598757452 NPPES
Oregon MEDICAID 134800

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