Healthcare Provider Details

I. General information

NPI: 1336122449
Provider Name (Legal Business Name): MARTHA ANN OCHOA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 0221
CEDAR FALLS IA
50614-0001
US

IV. Provider business mailing address

BUILDING 0221
CEDAR FALLS IA
50614-0001
US

V. Phone/Fax

Practice location:
  • Phone: 319-273-2009
  • Fax: 319-273-7030
Mailing address:
  • Phone: 319-273-2009
  • Fax: 319-273-7030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29385
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: