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1396113262 NPI number — MIGUEL ANGEL OCHOA JR. DPT

NPI Number: 1396113262
Health Care Provider/Practitioner: MIGUEL ANGEL OCHOA JR. DPT

Information about “1396113262” NPI (MIGUEL ANGEL OCHOA JR. DPT) exists in 1396113262 in HTML format HTML  |  1396113262 in plain Text format TXT  |  1396113262 in PDF (Portable Document Format) PDF  |  1396113262 in an XML format XML  formats.

NPI Number : 1396113262 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396113262",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OCHOA",
    "FirstName": "MIGUEL",
    "MiddleName": "ANGEL",
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "OCHOA",
    "OtherFirstName": "MIKE",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": "JR.",
    "OtherCredential": "DPT",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "4638 STORROW WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SACRAMENTO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95842-3650",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "559-936-8261",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4638 STORROW WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SACRAMENTO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95842-3650",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "559-936-8261",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/09/2015",
    "LastUpdateDate": "02/22/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "42920",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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