Provider Demographics
NPI:1255318788
Name:DE OCAMPO, JOSE Z (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:Z
Last Name:DE OCAMPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOEL
Other - Middle Name:Z
Other - Last Name:DE OCAMPO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10210 N 92ND ST. SUITE 302
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:480-718-9241
Mailing Address - Fax:480-718-9248
Practice Address - Street 1:10210 N 92ND ST. SUITE 302
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-718-9241
Practice Address - Fax:480-718-9248
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ354892084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ2089786OtherCIGNA
AZ1255318788OtherBC/BS AZ
AZ114149Medicaid
AZ1255318788OtherBC/BS AZ
AZ2089786OtherCIGNA