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General NPI Number Information
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NPI Number | 1043711476
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Entity Type | Organization
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Legal Business Name | ULTRACARE HOSPICE & PALLIATIVE CARE, INC.
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 970 N TUSTIN AVE STE 101
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City | ANAHEIM
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State | CA
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Zip | 92807-1761
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Country | US
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Telephone | 714-603-7613
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Fax | 657-208-3780
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Provider Business Mailing Address
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Address Line | 970 N TUSTIN AVE STE 101
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City | ANAHEIM
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State | CA
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Zip | 92807-1761
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Country | US
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Telephone | 714-603-7613
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Fax | 657-208-3780
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. MARIALISA MENDOZA
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Credential |
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Telephone | 714-504-5371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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