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NPI 1013730167

NPI 1013730167 : REBECCA WINGEN : RANCHO SANTA MARGARITA, CA

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General NPI Number Information
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    NPI Number           |    1013730167
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA WINGEN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/06/2024
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    Last Update Date     |    11/06/2024
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Provider Practice Location Address
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    Address Line         |    22342 EL PASEO STE G 
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    City                 |    RANCHO SANTA MARGARITA
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    State                |    CA
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    Zip                  |    92688-5804
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    Country              |    US
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    Telephone            |    949-876-5329
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    26 DUSTY TRL 
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    City                 |    TRABUCO CANYON
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    State                |    CA
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    Zip                  |    92679-5344
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    
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