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General NPI Number Information
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NPI Number | 1295781193
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Entity Type | Individual
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Provider Name | ANNA C. DEOCAMPO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 5020 E SHEA BLVD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4603
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Country | US
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Telephone | 480-443-0050
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Fax | 480-443-4018
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Provider Business Mailing Address
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Address Line | 5020 E SHEA BLVD SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-4603
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Country | US
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Telephone | 480-443-0050
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Fax | 480-443-4018
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number | 35604
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20906
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License Number State | SC
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