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NPI 1114115094

NPI 1114115094 : ROBERT SALVAGGIO DPT : LAGUNA NIGUEL, CA

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General NPI Number Information
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    NPI Number           |    1114115094
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT SALVAGGIO DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/04/2007
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    Last Update Date     |    10/04/2007
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Provider Practice Location Address
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    Address Line         |    25312 VIA PIEDRA ROJA 
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    City                 |    LAGUNA NIGUEL
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    State                |    CA
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    Zip                  |    92677-1824
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    Country              |    US
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    Telephone            |    949-495-0772
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    Fax                  |    949-495-0772
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Provider Business Mailing Address
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    Address Line         |    PO BOX 7241 
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    City                 |    LAGUNA NIGUEL
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    State                |    CA
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    Zip                  |    92607-7241
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT 24025
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    License Number State |    CA
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