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General NPI Number Information
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NPI Number | 1043848872
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Entity Type | Organization
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Legal Business Name | NELSON MD AND LOCHHEAD MD, A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/28/2020
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 28202 CABOT RD STE 635
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1222
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Country | US
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Telephone | 203-482-7227
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Fax |
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Provider Business Mailing Address
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Address Line | 28202 CABOT RD STE 635
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1222
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Country | US
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Telephone | 949-236-7223
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELE NELSON
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Credential | MD
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Telephone | 949-236-7223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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