Individual
JOSE A BOCANEGRA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10139 ROYALTON RD STE H, NORTH ROYALTON, OH 44133-4473
(440) 816-2878
Mailing address
PO BOX 638269, CINCINNATI, OH 45263-8269
(440) 816-2878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35082489
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350199
ANTHEM BLUE CROSS BLUE SH
OH
01
—
0007456582
AETNA PROVDER ID#
OH
01
—
1003087
QUALCHOICE
OH
01
—
2479442
UNITED HEALTHCARE
OH
Enumeration date
10/05/2006
Last updated
02/22/2022
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