Ocotillo Treatment Center, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

OCOTILLO TREATMENT CENTER, LLC

Practice address

3645 S Rome St Ste 204
Gilbert, AZ 85297-7338

Phone

(480) 771-4400

NPI assigned

Jun 4, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Taicha L Maldonado, MANAGER

Title

Manager

Phone

(480) 441-7700

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1871085902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 S ROME ST STE 204",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977338",
            "telephone_number": "480-771-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 S ROME ST STE 204",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977338",
            "telephone_number": "480-771-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "TAICHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-441-7700",
        "authorized_official_credential": "MANAGER"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Danielle Ocampo, SLT, SLPL
• Ocean Spine PLLC
• Latrice C Ochieng, MLE, CLT, HHP, BCHN
• Risa M Ochoa Jr.
• Ocotillo Surgery Center LLC
• Jwan Odisho, AGACNP-BC
• Leo Odle, DO
• Marcia Odonnell
• Kristin N Oehler, APRN;FNP-C
• John Cummins Oertle III, N.D.

• Interventional Pain Medicine Physician in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Interventional Pain Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.