Healthcare Provider Details

I. General information

NPI: 1255637781
Provider Name (Legal Business Name): CESAR OMAR OCHOA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE
FRESNO CA
93720-3309
US

IV. Provider business mailing address

2100 POWELL ST STE 900
EMERYVILLE CA
94608-1844
US

V. Phone/Fax

Practice location:
  • Phone: 805-776-3541
  • Fax:
Mailing address:
  • Phone: 510-851-7423
  • Fax: 510-879-9120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA115616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: