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General NPI Number Information
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NPI Number | 1134176969
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Entity Type | Individual
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Provider Name | BROOKE CALDWELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 5725 W LAS POSITAS BLVD
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City | PLEASANTON
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State | CA
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Zip | 94588-4054
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Country | US
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Telephone | 925-416-6789
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Fax | 925-416-6758
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Provider Business Mailing Address
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Address Line | 5725 W LAS POSITAS BLVD
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City | PLEASANTON
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State | CA
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Zip | 94588-4054
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Country | US
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Telephone | 925-416-6789
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Fax | 925-416-6758
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A46292
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License Number State | CA
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