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General NPI Number Information
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NPI Number | 1023197944
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Entity Type | Organization
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Legal Business Name | COUNTY OF SAN MATEO
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 795 WILLOW RD BLDG 334
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City | MENLO PARK
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State | CA
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Zip | 94025-2539
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Country | US
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Telephone | 650-599-3890
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Fax |
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Provider Business Mailing Address
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Address Line | 222 W 39TH AVE
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City | SAN MATEO
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State | CA
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Zip | 94403-4364
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Country | US
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Telephone | 650-573-2222
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Fax |
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Authorized Official
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Title or Position | REIMBURSEMENT
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Name | KRIS ROZZI
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Credential |
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Telephone | 650-573-2120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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