| Brenda M.k. Camacho M.d. Llc | |
|
615 Ponahawai St Ste 201 Hilo HI 96720-7665 | |
| (808) 935-1621 | |
| (808) 935-5959 |
| Full Name | Brenda M.k. Camacho M.d. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 615 Ponahawai St Ste 201, Hilo, Hawaii |
| Authorized Official Name and Position | Brenda Michiko Camacho (PHYSICIAN) |
| Authorized Official Contact | 8089351621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda M.k. Camacho M.d. Llc 615 Ponahawai St Hilo HI 96720-7665 Ph: (808) 935-1621 | Brenda M.k. Camacho M.d. Llc 615 Ponahawai St Ste 201 Hilo HI 96720-7665 Ph: (808) 935-1621 |
| NPI Number | 1467756536 |
|---|---|
| Provider Enumeration Date | 01/04/2011 |
| Last Update Date | 04/18/2024 |
| Medicare PECOS PAC ID | 9133661291 |
|---|---|
| Medicare Enrollment ID | O20240605001164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467756536 | NPI | - | NPPES |
| 002084-02 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD9518 (Hawaii) | Primary |
| Provider Name | Brenda M Camacho |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255407995 PECOS PAC ID: 0042470429 Enrollment ID: I20120321000718 |
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