Provider Demographics
NPI:1730429051
Name:OCHOA, CHRISTIAN TANON
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:TANON
Last Name:OCHOA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 S PECOS RD APT 123
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2313
Mailing Address - Country:US
Mailing Address - Phone:407-300-7124
Mailing Address - Fax:
Practice Address - Street 1:3225 S PECOS RD APT 123
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-2313
Practice Address - Country:US
Practice Address - Phone:407-300-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner