Provider Demographics
NPI:1245664812
Name:DEMIAN J OCHOA, OD, PC
Entity type:Organization
Organization Name:DEMIAN J OCHOA, OD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMIAN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-913-3321
Mailing Address - Street 1:133 PHINNEYS LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-2949
Mailing Address - Country:US
Mailing Address - Phone:215-913-3321
Mailing Address - Fax:
Practice Address - Street 1:137 TEATICKET HWY
Practice Address - Street 2:INSIDE WALMART VISION CENTER
Practice Address - City:TEATICKET
Practice Address - State:MA
Practice Address - Zip Code:02536-5659
Practice Address - Country:US
Practice Address - Phone:508-548-2147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4695152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty