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General NPI Number Information
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NPI Number | 1194392357
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Entity Type | Organization
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Legal Business Name | PEACEFUL PROMISE, INC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 440 S. MELROSE DRIVE SUITE 205
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City | VISTA
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State | CA
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Zip | 92081-9208
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Country | US
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Telephone | 858-888-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 1444 BELMONT PARK RD
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City | OCEANSIDE
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State | CA
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Zip | 92057-5727
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Country | US
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Telephone | 858-382-3328
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JASON DESADIER
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Credential | DO
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Telephone | 707-334-6089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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