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General NPI Number Information
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NPI Number | 1144115759
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Entity Type | Individual
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Provider Name | ROLANDO UNTALAN GOCHANGCO SAINT VINCENT HEALTH
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Gender | Male
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 253 VOYAGER DR
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City | VALLEJO
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State | CA
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Zip | 94590-4013
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Country | US
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Telephone | 707-392-9948
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Fax |
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Provider Business Mailing Address
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Address Line | 253 VOYAGER DR
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City | VALLEJO
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State | CA
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Zip | 94590-4013
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Country | US
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Telephone | 707-392-9948
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Fax |
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 11719434
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License Number State | CA
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