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General NPI Number Information
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NPI Number | 1255054375
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Entity Type | Organization
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Legal Business Name | NOVACARE SURGICAL CENTER A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 12894 HARBOR BLVD
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City | GARDEN GROVE
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State | CA
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Zip | 92840-5807
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Country | US
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Telephone | 714-537-4400
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Fax | 714-537-0400
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Provider Business Mailing Address
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Address Line | 12894 HARBOR BLVD
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City | GARDEN GROVE
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State | CA
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Zip | 92840-5807
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Country | US
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Telephone | 714-537-4400
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Fax | 714-537-0400
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANTOINETTE MARIE COX
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Credential |
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Telephone | 714-469-1771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State |
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