Basic Information
| Provider Information | |||||||||
| NPI: | 1629455050 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OCHIAI | ||||||||
| FirstName: | KEN | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25215 OAK ST | ||||||||
| Address2: | APT #12 | ||||||||
| City: | LOMITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907172261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109103490 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1234 NAPIER AVE | ||||||||
| Address2: | |||||||||
| City: | SAINT JOSEPH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490852112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699838300 | ||||||||
| FaxNumber: | 2699854535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2015 | ||||||||
| LastUpdateDate: | 10/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301116304 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 4301116304 | MI | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.