| Miguel Dominguez Camacho, MD | |
|
4581 10th St, Suite C, Guadalupe, CA 93434-1454 | |
| (805) 343-5577 | |
| (805) 343-5578 |
| Full Name | Miguel Dominguez Camacho |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 4581 10th St, Guadalupe, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093746364 | NPI | - | NPPES |
| HAP70986F | Other | CA | FAMILY PACK |
| CJ5474 | Other | CA | MEDICARE RAILROAD GROUP PTAN # |
| P00725474 | Other | CA | MEDICARE RAILROAD GROUP MEMBER PTAN# |
| 00A535410 | Medicaid | CA | |
| FHC70986F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A53541 (California) | Primary |
| Entity Name | Community Health Centers Of The Central Coast Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336166248 PECOS PAC ID: 7416868120 Enrollment ID: O20040115001161 |
| Mailing Address | Practice Location Address |
|---|---|
| Miguel Dominguez Camacho, MD 2050 S Blosser Rd, Santa Maria, CA 93458-7310 Ph: (805) 361-8028 | Miguel Dominguez Camacho, MD 4581 10th St, Suite C, Guadalupe, CA 93434-1454 Ph: (805) 343-5577 |
Dr. Christina Anne Pinto, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4723 W Main St Ste H, Guadalupe, CA 93434 Phone: 805-334-3557 Fax: 805-343-5578 | |
Archana Mallela, Family Medicine Medicare: Medicare Enrolled Practice Location: 4723 W Main St Ste H, Guadalupe, CA 93434 Phone: 805-343-5577 |