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General NPI Number Information
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NPI Number | 1013171255
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Entity Type | Organization
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Legal Business Name | CALIFORNIA MEDICAL SUPPLY
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 30199 SKIPPERS WAY DR
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City | CANYON LAKE
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State | CA
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Zip | 92587-7405
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Country | US
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Telephone | 951-741-5884
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Fax |
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Provider Business Mailing Address
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Address Line | 30199 SKIPPERS WAY DR
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City | CANYON LAKE
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State | CA
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Zip | 92587-7405
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Country | US
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Telephone | 951-741-5884
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | STEVE ANDREW WILCOX
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Credential |
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Telephone | 951-741-5884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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