Provider Demographics
NPI:1699732149
Name:OCAMPO, RESURRECCION MACAPINLAC (MD)
Entity type:Individual
Prefix:DR
First Name:RESURRECCION
Middle Name:MACAPINLAC
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WIGWAM PKWY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7112
Mailing Address - Country:US
Mailing Address - Phone:702-407-1561
Mailing Address - Fax:702-407-1563
Practice Address - Street 1:2500 WIGWAM PKWY
Practice Address - Street 2:SUITE 111
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7112
Practice Address - Country:US
Practice Address - Phone:702-407-1561
Practice Address - Fax:702-407-1563
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
R7106OtherBLUE CROSS BLUE SHIELD
H03502Medicare UPIN
R7106OtherBLUE CROSS BLUE SHIELD