Healthcare Provider Details

I. General information

NPI: 1295781193
Provider Name (Legal Business Name): ANNA C. DEOCAMPO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA CHRISTINA CATINDIG DE OCAMPO M.D.

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 E SHEA BLVD SUITE 100
SCOTTSDALE AZ
85254-4603
US

IV. Provider business mailing address

5020 E SHEA BLVD SUITE 100
SCOTTSDALE AZ
85254-4603
US

V. Phone/Fax

Practice location:
  • Phone: 480-443-0050
  • Fax: 480-443-4018
Mailing address:
  • Phone: 480-443-0050
  • Fax: 480-443-4018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number35604
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20906
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: