Provider Demographics
NPI:1033664735
Name:JOCHEN MEDICAL WEIGHT LOSS, APC
Entity Type:Organization
Organization Name:JOCHEN MEDICAL WEIGHT LOSS, APC
Other - Org Name:MEDI-WEIGHTLOSS RANCHO MIRAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ELIAS
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-423-4043
Mailing Address - Street 1:42600 MIRAGE RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4127
Mailing Address - Country:US
Mailing Address - Phone:760-423-4090
Mailing Address - Fax:
Practice Address - Street 1:42600 MIRAGE RD
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4127
Practice Address - Country:US
Practice Address - Phone:760-423-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA702162083B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Single Specialty