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General NPI Number Information
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NPI Number | 1083823512
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Entity Type | Organization
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Legal Business Name | RADY CHILDRENS HOSPITAL
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3142 VISTA WAY SUITE 207
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City | OCEANSIDE
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State | CA
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Zip | 92056-3619
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Country | US
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Telephone | 760-967-7082
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Fax |
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Provider Business Mailing Address
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Address Line | 1659 COUNTRYSIDE DR
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City | VISTA
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State | CA
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Zip | 92081-8725
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Country | US
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Telephone | 760-734-1629
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Fax |
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Authorized Official
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Title or Position | CHILD FAMILY SPECIALIST
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Name | MRS. LESLIE NEFF
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Credential |
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Telephone | 760-967-7082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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