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General NPI Number Information
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NPI Number | 1124068523
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Entity Type | Organization
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Legal Business Name | EYE SURGICAL & MEDICAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 11/18/2023
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Provider Practice Location Address
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Address Line | 5021 W NOBLE AVE SUITE A
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City | VISALIA
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State | CA
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Zip | 93277-8310
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Country | US
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Telephone | 559-627-9393
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Fax | 559-627-1624
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Provider Business Mailing Address
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Address Line | 5021 W NOBLE AVE SUITE A
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City | VISALIA
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State | CA
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Zip | 93277-8310
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Country | US
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Telephone | 559-627-9393
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Fax | 559-627-1624
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL I BOONE
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Credential | M.D.
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Telephone | 559-627-9393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 31645
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License Number State | CA
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