Provider Demographics
NPI:1063396570
Name:CAMPOS, CARLOS H
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:H
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4479 DELTA AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1103
Mailing Address - Country:US
Mailing Address - Phone:562-513-0832
Mailing Address - Fax:
Practice Address - Street 1:4479 DELTA AVE UNIT C
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1103
Practice Address - Country:US
Practice Address - Phone:562-513-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)