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General NPI Number Information
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NPI Number | 1124037411
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN CARE MEDICAL CLINIC
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 03/02/2012
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Provider Practice Location Address
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Address Line | 2656 EDITH AVE STE B
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City | REDDING
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State | CA
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Zip | 96001-3043
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Country | US
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Telephone | 530-247-3733
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Fax | 530-243-6807
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Provider Business Mailing Address
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Address Line | PO BOX 496084
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City | REDDING
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State | CA
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Zip | 96049-6084
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Country | US
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Telephone | 530-247-3733
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Fax | 530-246-0644
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | LEONARD J SOLONIUK
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Credential | M.D.
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Telephone | 530-247-3733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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