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General NPI Number Information
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NPI Number | 1205171139
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Entity Type | Organization
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Legal Business Name | SPECIALTY CARE CLINIC
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Dates
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Enumeration Date | 12/04/2012
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 451 W GONZALES RD 220
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City | OXNARD
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State | CA
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Zip | 93036-9004
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Country | US
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Telephone | 805-983-0300
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Fax | 805-983-0336
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Provider Business Mailing Address
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Address Line | 451 W GONZALES RD 220
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City | OXNARD
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State | CA
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Zip | 93036-9004
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Country | US
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Telephone | 805-983-0300
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Fax | 805-983-0336
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL R SCHILLING
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Credential | M.D.
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Telephone | 805-983-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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