Provider Demographics
NPI:1295946010
Name:DE JESUS, JOSEPH ANTHONY OCAMPO (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH ANTHONY
Middle Name:OCAMPO
Last Name:DE JESUS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13280 EVENING CREEK DR S STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 SALEM WOODSTOWN RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-339-6054
Practice Address - Fax:856-935-6714
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC2005302085R0202X
PAMD4329552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology