Provider Demographics
NPI:1023089166
Name:OCHOA, JESUS M (MD)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:M
Last Name:OCHOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-0529
Mailing Address - Country:US
Mailing Address - Phone:970-323-6141
Mailing Address - Fax:855-299-8071
Practice Address - Street 1:1010 S RIO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4831
Practice Address - Country:US
Practice Address - Phone:970-497-3333
Practice Address - Fax:855-299-7837
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO46428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18825265Medicaid
CO18825265Medicaid