MR. ILDEFONSO TIMPLE CAMPOMANES III (NPI# 1588877666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588877666 |
| Entity Type | Individual |
| Full Name | MR. ILDEFONSO TIMPLE CAMPOMANES III |
| Credential | P.T. |
| Practice Address |
1281 Craig Ave Lakeport CA 95453-5704 |
| Practice Telephone | 7072634564 |
| Practice Fax Number | 7072634572 |
| Mailing Telephone | 7072634564 |
| Mailing Fax Number | 7072634572 |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
34058 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154374189 | Ildefonso A Campomanes | Anesthesiology | 332 W Broadway, Louisville, KY 40202-2130 | 2006-05-19 |
| Street Address |
1281 CRAIG AVE |
| City | LAKEPORT |
| State | CA |
| Zip Code | 95453-5704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184788531 | Matthew J. Garrean | Physical Therapist | 1281 Craig Ave, Lakeport, CA 95453-5704 | 2006-12-20 |
| 1033431630 | Elmezen Oliverio Martin | Dental Hygienist | 1281 Craig Ave, Lakeport, CA 95453-5704 | 2010-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1285000810 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 14678 Lakeshore Boulevard, Clearlake, CA 95453 | 2015-08-18 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
| Find all providers in zip 95453 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063311 | Kayla Utley | Physical Therapist | 5201 Norris Canyon Rd Ste 230, San Ramon, CA 94583-5405 | 2020-11-06 |
| 1184225054 | Vuk Ekmecic | Physical Therapist | 7908 Rancho Fanita Dr Spc 23, Santee, CA 92071-3421 | 2020-11-05 |
| 1932700283 | Christopher Lui | Physical Therapist | 21621 E Bluebell Ct, Walnut, CA 91789-1443 | 2020-11-03 |
| 1952900789 | Sierra Speck | Physical Therapist | 11701 Wilshire Blvd Ste 14b1, Los Angeles, CA 90025-1547 | 2020-10-22 |
| 1992312086 | Heidi Lynne Anders | Physical Therapist | 5805 W 8th St Apt 205, Los Angeles, CA 90036-4576 | 2020-09-23 |
| 1578176780 | Patricia Isabella Commer | Physical Therapist | 4146 Randolph Ave, Oakland, CA 94602-1314 | 2020-08-26 |
| 1376151126 | Yifu Zhou | Physical Therapist | 1625 W Olympic Blvd Ste 790, Los Angeles, CA 90015-3809 | 2020-07-17 |
| 1033732250 | Sync Physical Therapy & Yoga Inc | Physical Therapist | 5100 Marlborough Dr Ste 101, San Diego, CA 92116-2020 | 2020-05-21 |
| 1043830961 | Dr. Holly Physical Therapy | Physical Therapist | 4500 Shepard St, Bakersfield, CA 93313-2326 | 2020-04-21 |
| 1861011744 | Lauren Jarmusz | Physical Therapist | 1107 2nd Ave Apt 408, Redwood City, CA 94063-4036 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.