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General NPI Number Information
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NPI Number | 1184165086
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY REGISTRY
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 24551 RAYMOND WAY SUITE 145
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City | LAKE FOREST
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State | CA
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Zip | 92630-4400
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Country | US
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Telephone | 949-600-7031
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Fax | 949-600-6183
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Provider Business Mailing Address
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Address Line | 24451 RAYMOND WAY, SUITE 145
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City | LAGUNA HILLS
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State | CA
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Zip | 92630
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Country | US
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Telephone | 949-600-7031
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Fax | 949-600-6183
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BELINDA SAPPARI
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Credential |
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Telephone | 949-600-7031
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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 | 304700060
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License Number State | CA
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