Provider Demographics
NPI:1962615633
Name:CAMP, H EDWARD (DC)
Entity type:Individual
Prefix:
First Name:H
Middle Name:EDWARD
Last Name:CAMP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:H.
Other - Middle Name:EDWARD
Other - Last Name:CAMP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:5758 GEARY BLVD #244
Mailing Address - Street 2:H. EDWARD CAMP D.C.
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121
Mailing Address - Country:US
Mailing Address - Phone:415-922-2225
Mailing Address - Fax:
Practice Address - Street 1:4224 CALIFORNIA ST. #203
Practice Address - Street 2:H. EDWARD CAMP D.C.
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-922-2225
Practice Address - Fax:415-921-6206
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23427111N00000X, 111NI0013X, 111NS0005X
CA950433111NI0013X
CA3391111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA915751OtherQUALIFIED MEDICAL EVALUAT
CAU57370Medicare UPIN