Provider Demographics
NPI:1386734770
Name:OCHABSKI, RENATA (MD)
Entity type:Individual
Prefix:DR
First Name:RENATA
Middle Name:
Last Name:OCHABSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7334 GIRARD AVE. #202
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-459-8224
Mailing Address - Fax:858-459-4062
Practice Address - Street 1:7334 GIRARD AVE
Practice Address - Street 2:#202
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-5141
Practice Address - Country:US
Practice Address - Phone:858-459-8224
Practice Address - Fax:858-459-4062
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66153174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH20736Medicare UPIN
CAA66153Medicare ID - Type UnspecifiedLICENSE NUMBER