Provider Demographics
NPI:1437495173
Name:OCAMPO, GINA GUARING (PA-C)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:GUARING
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19202 AMALFI COURT
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:823 S MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3408
Practice Address - Country:US
Practice Address - Phone:951-270-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22427363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant