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General NPI Number Information
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NPI Number | 1063863561
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Entity Type | Organization
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Legal Business Name | BUENA SALUD MEDICAL CLINIC,INC
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 212 S ATLANTIC BLVD SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90022-1754
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Country | US
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Telephone | 323-597-0053
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Fax | 323-597-0078
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Provider Business Mailing Address
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Address Line | 212 S ATLANTIC BLVD SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90022-1754
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Country | US
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Telephone | 323-597-0053
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Fax | 323-597-0078
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Authorized Official
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Title or Position | CEO
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Name | MRS. LAGRIMAS HARO
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Credential |
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Telephone | 323-597-0053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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