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General NPI Number Information
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NPI Number | 1174503429
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MEDICAL CENTER
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 98 E LAKE MEAD PKWY # 301
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City | HENDERSON
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State | NV
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Zip | 89015
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Country | US
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Telephone | 702-577-0543
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Fax | 515-583-4374
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Provider Business Mailing Address
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Address Line | 110 N BOULDER HWY # 120-08
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City | HENDERSON
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State | NV
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Zip | 89015
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Country | US
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Telephone | 702-577-0543
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Fax | 515-583-4374
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Authorized Official
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Title or Position | CMO
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Name | DAVID RIVAS
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Credential | DO
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Telephone | 702-526-5078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0926
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0926
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License Number State | NV
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