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General NPI Number Information
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NPI Number | 1114212685
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Entity Type | Organization
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Legal Business Name | CITRUS VALLEY PHYSICIANS GROUP
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 43 CORPORATE PARK SUITE 206
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City | IRVINE
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State | CA
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Zip | 92606-5137
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Country | US
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Telephone | 949-474-6999
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Fax | 949-474-6997
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Provider Business Mailing Address
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Address Line | 43 CORPORATE PARK SUITE 206
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City | IRVINE
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State | CA
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Zip | 92606-5137
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Country | US
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Telephone | 949-474-6999
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Fax | 949-474-6997
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | DR. RAJESH RAO
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Credential | MD
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Telephone | 949-474-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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