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General NPI Number Information
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NPI Number | 1053994582
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Entity Type | Organization
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Legal Business Name | SKYWEST MEDICAL
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 05/03/2021
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Provider Practice Location Address
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Address Line | 9420 RESEDA BLVD # 503
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2932
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Country | US
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Telephone | 818-581-8396
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Fax | 818-280-6499
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Provider Business Mailing Address
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Address Line | 9420 RESEDA BLVD # 503
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2932
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Country | US
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Telephone | 818-581-8396
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RANDALL CALDRON
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Credential | MD
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Telephone | 818-923-8812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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