Provider Demographics
NPI:1871537191
Name:OJEDA-FOURNIER, HAYDEE (MD)
Entity type:Individual
Prefix:DR
First Name:HAYDEE
Middle Name:
Last Name:OJEDA-FOURNIER
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 1:3855 HEALTH SCIENCES DRIVE
Mailing Address - Street 2:MC0846
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0846
Mailing Address - Country:US
Mailing Address - Phone:858-822-6121
Mailing Address - Fax:858-822-6124
Practice Address - Street 1:3855 HEALTH SCIENCES DRIVE
Practice Address - Street 2:MC0846
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0846
Practice Address - Country:US
Practice Address - Phone:858-822-6121
Practice Address - Fax:858-822-6124
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA994622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64097397Medicaid
OH000000361514OtherANTHEM
OH2552456Medicaid
OH16-04995OtherUNITED HEALTHCARE
IN200175160Medicaid
OH7519694OtherAETNA
KY64097397Medicaid
OH2552456Medicaid