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General NPI Number Information
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NPI Number | 1194885467
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Entity Type | Individual
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Provider Name | CHRISTOPHER SHEAN WILKINS PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/09/2006
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 103 GREENWICH CT
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City | SAN RAMON
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State | CA
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Zip | 94582-2800
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Country | US
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Telephone | 925-628-6556
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Fax | 925-828-5084
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Provider Business Mailing Address
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Address Line | 103 GREENWICH CT
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City | SAN RAMON
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State | CA
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Zip | 94582-2800
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Country | US
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Telephone | 925-628-6556
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Fax | 925-828-5084
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA12886
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License Number State | CA
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