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General NPI Number Information
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NPI Number | 1053683953
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA HOSPITALIST GROUP
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 5457 TURQUOISE AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-1227
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Country | US
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Telephone | 909-527-3651
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Fax |
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Provider Business Mailing Address
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Address Line | 5457 TURQUOISE AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-1227
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Country | US
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Telephone | 909-527-3651
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/CEO/PRESIDENT
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Name | DR. ALIDAD M ZADEH
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Credential | D.O.
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Telephone | 909-527-3651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 20A10575
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License Number State | CA
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