Healthcare Provider Details

I. General information

NPI: 1689937393
Provider Name (Legal Business Name): JEANNE OCHEZE HUNTER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANNE OCHEZE MBAGWU DO

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 COFFEE RD
MODESTO CA
95355-4201
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 209-569-7408
  • Fax: 209-491-7587
Mailing address:
  • Phone: 800-470-0071
  • Fax: 906-854-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDR.0053057
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A16241
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: