Basic Information
| Provider Information | |||||||||
| NPI: | 1649503814 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OCHOA-BUCK | ||||||||
| FirstName: | JULISSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | OCHOA | ||||||||
| OtherFirstName: | JULISSA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3690 S PARK AVE STE 805 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857135042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206166760 | ||||||||
| FaxNumber: | 5206166799 | ||||||||
| Practice Location | |||||||||
| Address1: | 3690 S PARK AVE STE 805 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857135042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206166760 | ||||||||
| FaxNumber: | 5206166799 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2009 | ||||||||
| LastUpdateDate: | 04/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 42319 | AZ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.