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General NPI Number Information
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NPI Number | 1164550794
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Entity Type | Organization
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Legal Business Name | FABIO OCHOA, M.D
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 1716 NORTH RD SE
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City | WARREN
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State | OH
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Zip | 44484-2907
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Country | US
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Telephone | 330-399-9776
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Fax | 330-399-8665
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Provider Business Mailing Address
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Address Line | 1716 NORTH RD SE
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City | WARREN
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State | OH
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Zip | 44484-2907
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Country | US
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Telephone | 330-399-9776
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Fax | 330-399-8665
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Authorized Official
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Title or Position | OWNER
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Name | DR. FABIO V OCHOA
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Credential | M.D.
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Telephone | 330-399-9776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 35-03-4629
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License Number State | OH
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