Provider Demographics
NPI:1215050398
Name:CAMPOS, BERNARDO DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARDO
Middle Name:DANIEL
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N CAMPBELL AVE RM 4327
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-0001
Mailing Address - Country:US
Mailing Address - Phone:520-626-4300
Mailing Address - Fax:520-626-9226
Practice Address - Street 1:1501 N CAMPBELL AVE RM 4327
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-626-4300
Practice Address - Fax:520-626-9226
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA114423208600000X
PR19173208600000X
NY327170204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery