Provider Demographics
NPI:1114715570
Name:KAMERON PLACE LLC
Entity type:Organization
Organization Name:KAMERON PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DHANA
Authorized Official - Middle Name:CABANTAC
Authorized Official - Last Name:REMOT
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:272-687-9431
Mailing Address - Street 1:2932 LUCIA JADE LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-3700
Mailing Address - Country:US
Mailing Address - Phone:727-687-9431
Mailing Address - Fax:
Practice Address - Street 1:794 MARSOPA DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6437
Practice Address - Country:US
Practice Address - Phone:727-687-9431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility