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General NPI Number Information
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NPI Number | 1013463991
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Entity Type | Organization
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Legal Business Name | CAMARILLO ENDOSCOPY CENTER LLC
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 04/24/2018
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Provider Practice Location Address
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Address Line | 4005 MISSION OAKS BLVD UNIT A
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City | CAMARILLO
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State | CA
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Zip | 93012-5156
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Country | US
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Telephone | 805-275-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 MISSION OAKS BLVD UNIT A
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City | CAMARILLO
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State | CA
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Zip | 93012-5156
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Country | US
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Telephone | 805-275-0200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHA ROJANY
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Credential | MD
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Telephone | 805-275-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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