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General NPI Number Information
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NPI Number | 1376674770
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Entity Type | Organization
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Legal Business Name | MARIO A. OCHOA M.D. INC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 3275 MCCALL AVE SUITE 102
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City | SELMA
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State | CA
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Zip | 93662-2505
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Country | US
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Telephone | 559-896-3808
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Fax | 559-896-3875
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Provider Business Mailing Address
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Address Line | 3275 MCCALL AVE SUITE 102
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City | SELMA
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State | CA
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Zip | 93662-2505
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Country | US
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Telephone | 559-896-3808
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Fax | 559-896-3875
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Authorized Official
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Title or Position | OWNER
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Name | MARIO OCHOA
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Credential | M.D.
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Telephone | 559-896-3808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A76417
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License Number State | CA
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