Provider Demographics
NPI:1871541771
Name:CAMPAIN, ALBERTO X (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:X
Last Name:CAMPAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4940 VAN NUYS BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1741
Mailing Address - Country:US
Mailing Address - Phone:818-528-1090
Mailing Address - Fax:818-528-1099
Practice Address - Street 1:4940 VAN NUYS BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1741
Practice Address - Country:US
Practice Address - Phone:818-528-1090
Practice Address - Fax:818-528-1099
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29432207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA83952Medicare UPIN
CAWA29432BMedicare ID - Type UnspecifiedMEDICARE PPIN NUMBER