Provider Demographics
NPI:1861609349
Name:JOSE M ROCAMORA, M.D. INC.
Entity type:Organization
Organization Name:JOSE M ROCAMORA, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROCAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:760-353-5933
Mailing Address - Street 1:1550 PEPPER DR
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-4165
Mailing Address - Country:US
Mailing Address - Phone:760-353-5933
Mailing Address - Fax:760-352-4300
Practice Address - Street 1:1550 PEPPER DR
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-4165
Practice Address - Country:US
Practice Address - Phone:760-353-5933
Practice Address - Fax:760-352-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA23537Medicare UPIN