Healthcare Provider Details

I. General information

NPI: 1295946010
Provider Name (Legal Business Name): JOSEPH ANTHONY OCAMPO DE JESUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SALEM WOODSTOWN RD
SALEM NJ
08079-2064
US

IV. Provider business mailing address

13280 EVENING CREEK DR S STE 110
SAN DIEGO CA
92128-4109
US

V. Phone/Fax

Practice location:
  • Phone: 856-339-6054
  • Fax: 856-935-6714
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA08363700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC200530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: