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General NPI Number Information
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NPI Number | 1124567334
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Entity Type | Organization
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Legal Business Name | PMNP MEDICAL SERVICES INC
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 433 S LAKE ST APT 214
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City | LOS ANGELES
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State | CA
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Zip | 90057-2740
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Country | US
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Telephone | 323-423-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 433 S LAKE ST APT 214
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City | LOS ANGELES
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State | CA
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Zip | 90057-2740
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Country | US
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Telephone | 323-423-2040
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. PEDRO ESTRADA MORANTE
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Credential | NP
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Telephone | 323-423-2040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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