Provider Demographics
NPI:1659706935
Name:MUNOZ OCA, JUAN EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:EDUARDO
Last Name:MUNOZ OCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12607 SE MILL PLAIN BLVD
Mailing Address - Street 2:CASCADE PARK MEDICAL OFFICE FAMILY MEDICINE
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-4098
Mailing Address - Country:US
Mailing Address - Phone:360-418-6001
Mailing Address - Fax:360-896-4472
Practice Address - Street 1:12607 SE MILL PLAIN BLVD
Practice Address - Street 2:CASCADE PARK MEDICAL OFFICE FAMILY MEDICINE
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-4098
Practice Address - Country:US
Practice Address - Phone:360-418-6001
Practice Address - Fax:360-896-4472
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60654646207Q00000X
PR18578208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice