Provider Demographics
NPI:1255672903
Name:OJEDA, MISAEL (N/A)
Entity Type:Individual
Prefix:
First Name:MISAEL
Middle Name:
Last Name:OJEDA
Suffix:
Gender:M
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 WENATCHEE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3355
Mailing Address - Country:US
Mailing Address - Phone:559-631-8440
Mailing Address - Fax:
Practice Address - Street 1:6725 WENATCHEE DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3355
Practice Address - Country:US
Practice Address - Phone:559-631-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner