Provider Demographics
NPI:1851393615
Name:OCHOA, MARIO ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:ALBERTO
Last Name:OCHOA
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 1:3275 MCCALL AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662
Mailing Address - Country:US
Mailing Address - Phone:559-896-3808
Mailing Address - Fax:559-896-3875
Practice Address - Street 1:3275 MCCALL AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662
Practice Address - Country:US
Practice Address - Phone:559-896-3808
Practice Address - Fax:559-896-3875
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2013-10-22
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-11
Provider Licenses
StateLicense IDTaxonomies
CAA76417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine