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General NPI Number Information
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NPI Number | 1144697129
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Entity Type | Organization
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Legal Business Name | ISLAND MEDICAL HOSPITALIST CARLSBAD LLC
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 2430 W PIERCE ST
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City | CARLSBAD
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State | NM
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Zip | 88220-3553
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Country | US
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Telephone | 240-686-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 12420 MILESTONE CENTER DR STE 200
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City | GERMANTOWN
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State | MD
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Zip | 20876-7111
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Country | US
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Telephone | 240-686-2300
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | AMY CARLEY
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Credential |
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Telephone | 240-686-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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